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Individual

GIOVANNI GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNA

Contact information

Practice address
3823 ROSSBERG ST SE, LACEY, WA 98503-3590
(253) 304-6202
Mailing address
3823 ROSSBERG ST SE, LACEY, WA 98503-3590
(253) 304-6202

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
754926
WA

Other

Enumeration date
04/15/2021
Last updated
04/15/2021
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