Provider Demographics
NPI:1881218139
Name:ORTIZ, DAISY VERONICA
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:VERONICA
Last Name:ORTIZ
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 1:8136 SWEETBRIER LN SE APT F302
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-9497
Mailing Address - Country:US
Mailing Address - Phone:915-996-3642
Mailing Address - Fax:
Practice Address - Street 1:6103 MOUNT TACOMA DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2727
Practice Address - Country:US
Practice Address - Phone:253-215-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker