Individual
GUADALUPE MICHELLE LOPEZ-PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
5912 NE 100TH CIR, VANCOUVER, WA 98686-6092
(360) 218-6317
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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