Provider Demographics
NPI:1134931736
Name:GARIBAY, VICTORIANO I (SUDPT)
Entity type:Individual
Prefix:MR
First Name:VICTORIANO
Middle Name:
Last Name:GARIBAY
Suffix:I
Gender:M
Credentials:SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3052
Mailing Address - Country:US
Mailing Address - Phone:509-415-8478
Mailing Address - Fax:
Practice Address - Street 1:766 S MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3052
Practice Address - Country:US
Practice Address - Phone:509-415-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61566537101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)