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Individual

MAGUEN LANDA-SAMANO DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
220 GERMANTOWN RD, TOPPENISH, WA 98948-9605
(509) 832-3124
Mailing address
220 GERMANTOWN RD, TOPPENISH, WA 98948-9605
(509) 832-3124

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60834054
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60834054
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
10/03/2018
Last updated
10/03/2018
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