Provider Demographics
NPI:1396201901
Name:SOLANO, ROMARIO
Entity Type:Individual
Prefix:
First Name:ROMARIO
Middle Name:
Last Name:SOLANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6771 NAVARRE COULEE RD
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-9397
Mailing Address - Country:US
Mailing Address - Phone:509-679-3495
Mailing Address - Fax:
Practice Address - Street 1:105 S APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8810
Practice Address - Country:US
Practice Address - Phone:509-682-6000
Practice Address - Fax:509-664-1037
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60906056101Y00000X
WALH61212490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2130047Medicaid