Provider Demographics
NPI:1073672069
Name:GALVEZ, REINA ERISEL (MSW, LMHC)
Entity Type:Individual
Prefix:MS
First Name:REINA
Middle Name:ERISEL
Last Name:GALVEZ
Suffix:
Gender:F
Credentials:MSW, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 228TH ST SE
Mailing Address - Street 2:APT D-103
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7428
Mailing Address - Country:US
Mailing Address - Phone:425-492-6242
Mailing Address - Fax:
Practice Address - Street 1:905 SPRUCE ST
Practice Address - Street 2:STE, 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2474
Practice Address - Country:US
Practice Address - Phone:206-548-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052520104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker