MEDICARE: SILVIA GUENDULEIN CRUZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SWI.LW.70020208	WA
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1285356733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SILVIA GUENDULEIN CRUZ

Provider Business Mailing Address
First Line	:	4507 S RAINIER CT
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99337-3918
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 S RAINIER CT
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99337-3918
Country	:	US
Telephone Number	:	509-802-6902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	03/04/2026

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Directions to “ SILVIA GUENDULEIN CRUZ ” Practice Location

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