Provider Demographics
NPI:1336294735
Name:GUERRERO, MARIE ELENA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:ELENA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ELENA
Other - Last Name:AVALOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1313 W WINE COUNTRY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1015
Mailing Address - Country:US
Mailing Address - Phone:509-882-3273
Mailing Address - Fax:509-882-5520
Practice Address - Street 1:1313 W WINE COUNTRY RD STE 101
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1015
Practice Address - Country:US
Practice Address - Phone:509-882-3273
Practice Address - Fax:509-882-5520
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052610101Y00000X
WACP00006228101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional