Basic Information
| Provider Information | |||||||||
| NPI: | 1851837223 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ-HERRERA | ||||||||
| FirstName: | RODRIGO | ||||||||
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| Credential: | CDP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3651 34TH AVE S | ||||||||
| Address2: | APT. B510 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981446964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098957740 | ||||||||
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| Practice Location | |||||||||
| Address1: | 506 N 40TH AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989084318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098957740 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2017 | ||||||||
| LastUpdateDate: | 01/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CP 60483026 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.