Provider Demographics
NPI:1376216259
Name:CASTILLO, VALERIE ANNE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANNE
Last Name:CASTILLO
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 1:139 PRINCE AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5528
Mailing Address - Country:US
Mailing Address - Phone:425-465-4226
Mailing Address - Fax:
Practice Address - Street 1:600 OAKESDALE AVE SW STE 104
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5226
Practice Address - Country:US
Practice Address - Phone:425-228-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61346257101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health