Healthcare Provider Details

I. General information

NPI: 1629553961
Provider Name (Legal Business Name): ALFREDO LEE GUZMAN MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 EASTMONT AVE
EAST WENATCHEE WA
98802-6602
US

IV. Provider business mailing address

600 ORONDO AVE STE 1
WENATCHEE WA
98801-2800
US

V. Phone/Fax

Practice location:
  • Phone: 509-662-6000
  • Fax:
Mailing address:
  • Phone: 509-662-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMC60737376
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG60164334
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: