Provider Demographics
NPI:1942455688
Name:GARCIA, GIMI REMEDIOS (MA ED)
Entity Type:Individual
Prefix:MS
First Name:GIMI
Middle Name:REMEDIOS
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 157
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:WA
Mailing Address - Zip Code:98244
Mailing Address - Country:US
Mailing Address - Phone:360-592-5262
Mailing Address - Fax:360-592-8202
Practice Address - Street 1:6746 MISSION RD.
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247
Practice Address - Country:US
Practice Address - Phone:360-966-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00041664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1981018Medicaid