Individual
MARIELI ELIZABETH GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3602 S 180TH ST, SEATAC, WA 98188-4367
(206) 555-1234
Mailing address
3602 S 180TH ST, SEATAC, WA 98188-4367
(206) 555-1234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/14/2022
Last updated
03/30/2023
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