Healthcare Provider Details

I. General information

NPI: 1679409569
Provider Name (Legal Business Name): LUCIA CASTRO ROMERO BA, R-AAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUCIA ALEJANDRO

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 14TH AVE
LONGVIEW WA
98632-2315
US

IV. Provider business mailing address

PO BOX 2394
LONGVIEW WA
98632-8455
US

V. Phone/Fax

Practice location:
  • Phone: 360-200-5419
  • Fax: 844-612-6673
Mailing address:
  • Phone: 360-200-5419
  • Fax: 844-612-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG70143081
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: