Healthcare Provider Details

I. General information

NPI: 1649194523
Provider Name (Legal Business Name): KIMBERLY CASTANEDA MARIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

139 S WORTHEN ST
WENATCHEE WA
98801-3890
US

IV. Provider business mailing address

139 S WORTHEN ST
WENATCHEE WA
98801-3890
US

V. Phone/Fax

Practice location:
  • Phone: 509-662-6761
  • Fax: 509-662-3182
Mailing address:
  • Phone: 509-662-6761
  • Fax: 509-662-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70116263
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: