Individual
GIANCARLO LUCA GENOVESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
2203 OLD HIGHWAY 99 S RD, MOUNT VERNON, WA 98273-9009
(360) 542-8810
(360) 542-8811
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-8005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61349244
WA
Other
Enumeration date
09/12/2022
Last updated
01/03/2023
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