Healthcare Provider Details

I. General information

NPI: 1366055824
Provider Name (Legal Business Name): CELINE MARIE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 BROADWAY STE 402
TACOMA WA
98402-4454
US

IV. Provider business mailing address

100 N HOWARD ST STE R
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 253-235-9130
  • Fax:
Mailing address:
  • Phone: 253-234-5745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70115101
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: