Provider Demographics
NPI:1386065472
Name:CORDOVA-FLORENDO, EILEEN
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:CORDOVA-FLORENDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:FLORENDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSWA
Mailing Address - Street 1:1244 STELLA RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-9761
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42 ELOCHOMAN VALLEY RD
Practice Address - Street 2:
Practice Address - City:CATHLAMET
Practice Address - State:WA
Practice Address - Zip Code:98612-9602
Practice Address - Country:US
Practice Address - Phone:360-795-8630
Practice Address - Fax:360-795-6224
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASWIA.SC.615044521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical