Provider Demographics
NPI:1346688330
Name:SUAREZ, AMARIS
Entity Type:Individual
Prefix:MISS
First Name:AMARIS
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E. MAIN ST.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344
Mailing Address - Country:US
Mailing Address - Phone:509-488-5611
Mailing Address - Fax:
Practice Address - Street 1:425 E. MAIN STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344
Practice Address - Country:US
Practice Address - Phone:509-488-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACAAR .CG.60325243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health