Healthcare Provider Details

I. General information

NPI: 1134719941
Provider Name (Legal Business Name): LINET MOLINERO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S 19TH ST
TACOMA WA
98405-2922
US

IV. Provider business mailing address

5405 MCKINLEY AVE
TACOMA WA
98404-2618
US

V. Phone/Fax

Practice location:
  • Phone: 253-396-1634
  • Fax:
Mailing address:
  • Phone: 253-230-9849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: