Provider Demographics
NPI:1659019735
Name:GUZMAN, IRIS (MSW)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:COVARRUBIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9702 183RD STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-6312
Mailing Address - Country:US
Mailing Address - Phone:253-881-9854
Mailing Address - Fax:
Practice Address - Street 1:9702 183RD STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6312
Practice Address - Country:US
Practice Address - Phone:253-881-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty