Individual
DILMA LIZET DEMARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
235 S 3RD ST, SHELTON, WA 98584-2255
(360) 868-2697
(360) 358-8524
Mailing address
235 S 3RD ST, SHELTON, WA 98584-2255
(360) 868-2697
(360) 358-8524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60871094
WA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
08/29/2019
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