Basic Information
| Provider Information | |||||||||
| NPI: | 1750528782 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUGUSHI | ||||||||
| FirstName: | ALMA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7507 NE 51ST ST | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986626007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609061190 | ||||||||
| FaxNumber: | 3609061193 | ||||||||
| Practice Location | |||||||||
| Address1: | 7507 NE 51ST ST | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986626007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609061190 | ||||||||
| FaxNumber: | 3609061193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2009 | ||||||||
| LastUpdateDate: | 05/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | RC00060164 | WA | Y | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | 60340051 | WA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.