Individual
GINA RAE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
30620 PACIFIC HWY S STE 107, FEDERAL WAY, WA 98003-4888
(253) 941-7555
(253) 941-0652
Mailing address
30620 PACIFIC HWY S STE 107, FEDERAL WAY, WA 98003-4888
(253) 941-7555
(253) 941-0652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60278263
WA
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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