MEDICARE: DIANA DOGANIERO DIAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		WA

General Provider Information

NPI Number	:	1730911520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA DOGANIERO DIAZ

Provider Business Mailing Address
First Line	:	8013 16TH ST SE
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8013 16TH ST SE
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-3849
Country	:	US
Telephone Number	:	786-812-2213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	05/15/2026

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Directions to “ DIANA DOGANIERO DIAZ ” Practice Location

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