Provider Demographics
NPI:1083288351
Name:OHMS-GANUELAS, REEVA (MSW)
Entity Type:Individual
Prefix:
First Name:REEVA
Middle Name:
Last Name:OHMS-GANUELAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N G ST
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-1477
Mailing Address - Country:US
Mailing Address - Phone:509-594-8411
Mailing Address - Fax:
Practice Address - Street 1:5301 TIETON DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3479
Practice Address - Country:US
Practice Address - Phone:509-965-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605907261041C0700X
WASC60590726104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical