Healthcare Provider Details

I. General information

NPI: 1184570186
Provider Name (Legal Business Name): FLOR CENICEROS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10604 NE HIGHWAY 99
VANCOUVER WA
98686-5613
US

IV. Provider business mailing address

10604 NE HIGHWAY 99
VANCOUVER WA
98686-5613
US

V. Phone/Fax

Practice location:
  • Phone: 360-644-1631
  • Fax: 360-644-1655
Mailing address:
  • Phone: 360-644-1631
  • Fax: 360-644-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29057
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: