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General NPI Number Information
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NPI Number | 1780724492
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Entity Type | Individual
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Provider Name | CASIMIRA DOMINGA VALDEZ L.M.P.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2402 BROADWAY ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3229
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Country | US
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Telephone | 360-241-6630
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Fax | 360-567-0620
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Provider Business Mailing Address
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Address Line | 2716 E 13TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-4799
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Country | US
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Telephone | 360-826-7266
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Fax | 360-826-7266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | WA00020974
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License Number State | WA
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