Healthcare Provider Details

I. General information

NPI: 1538726252
Provider Name (Legal Business Name): ALTA VISTA INTEGRATED LIFE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7282 STINSON AVE STE B
GIG HARBOR WA
98335-4930
US

IV. Provider business mailing address

PO BOX 10
BURLEY WA
98322-0010
US

V. Phone/Fax

Practice location:
  • Phone: 855-201-8141
  • Fax: 855-610-2353
Mailing address:
  • Phone: 855-201-8141
  • Fax: 855-610-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GINA CABRINHA
Title or Position: EXECUTIVE ADMINISTRATIVE ASSISTANT
Credential:
Phone: 253-525-9833