Basic Information
| Provider Information | |||||||||
| NPI: | 1942576996 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUDIEL | ||||||||
| FirstName: | WENDY | ||||||||
| MiddleName: | ARELY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5628 E SLAUSON AVE | ||||||||
| Address2: | |||||||||
| City: | COMMERCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900402922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3233189960 | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 NE PARK PLAZA DR STE 145 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986845873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607298383 | ||||||||
| FaxNumber: | 3607293534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2012 | ||||||||
| LastUpdateDate: | 05/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW105488 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LW61251581 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.