Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MG60226606 | WA |
NPI | 1003183963 |
---|---|
Provider Name | Julia Centeno Petro |
First Address | Seattle, WA 98124-1703 |
Second Address | Seattle, WA 98168-1615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2011 |
Last Update Date | 22/03/2017 |