Provider Demographics
NPI:1568243095
Name:CRUZ, ALMA INDIRA (CNA, AAC)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:INDIRA
Last Name:CRUZ
Suffix:
Gender:F
Credentials:CNA, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S LANE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2810
Mailing Address - Country:US
Mailing Address - Phone:206-682-2371
Mailing Address - Fax:206-682-2405
Practice Address - Street 1:1600 S LANE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2810
Practice Address - Country:US
Practice Address - Phone:206-682-2371
Practice Address - Fax:206-682-2405
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61405685101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty