Individual
CRISTINA SIDERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
12 S 8TH ST, YAKIMA, WA 98901-3020
(509) 454-4143
(509) 454-3651
Mailing address
PO BOX 2605, YAKIMA, WA 98907-2605
(509) 454-4143
(509) 454-3651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
RC00039778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC00039778
WASHINGTON STATE LICENSE
WA
Enumeration date
10/14/2009
Last updated
10/14/2009
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