Provider Demographics
NPI:1114599578
Name:ARREDONDO-RENTERIA, JORGE (MED&SOC INTERPRETER)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:ARREDONDO-RENTERIA
Suffix:
Gender:M
Credentials:MED&SOC INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EVERGREEN VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-9218
Mailing Address - Country:US
Mailing Address - Phone:360-957-3682
Mailing Address - Fax:
Practice Address - Street 1:2 EVERGREEN VILLAGE LN
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9218
Practice Address - Country:US
Practice Address - Phone:360-957-3682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)