Provider Demographics
NPI:1780730325
Name:LONDINO, STEPHEN L (CDP)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:LONDINO
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9930 EVERGREEN WAY
Mailing Address - Street 2:STE Z154
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3883
Mailing Address - Country:US
Mailing Address - Phone:425-263-3006
Mailing Address - Fax:425-263-3007
Practice Address - Street 1:9930 EVERGREEN WAY
Practice Address - Street 2:STE Z154
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3883
Practice Address - Country:US
Practice Address - Phone:425-263-3006
Practice Address - Fax:425-263-3007
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WACP00006068101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)