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Alejandro Antonio Tavira, CG60475423
Peer Specialist in University Place, Washington
NPI 1588136048

Alejandro Antonio Tavira is a Peer Specialist based in Tacoma, WA. Alejandro Antonio Tavira practices in University Place, WA and has the professional credentials of CG60475423. The NPI Number for Alejandro Antonio Tavira is 1588136048 and holds a License No. CG60475423 (Washington).

The current practice location address for Alejandro Antonio Tavira is 7610 40Th St W Ste 300, University Place, WA and can be reached out via phone at 253-830-6242.

Location: 7610 40Th St W Ste 300, University Place, WA, 98404-1031
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588136048
Provider Name
Alejandro Antonio Tavira
Credential
CG60475423
Provider Entity Type
Individual
Gender
Male
Address
7610 40Th St W Ste 300, University Place, WA, 98404-1031
Phone Number
253-830-6242
Fax Number
Provider Enumeration Date
12/21/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CG60475423 05 WA
institution
Provider Business Practice Location Address Details
Address
7610 40Th St W Ste 300
City
University Place
State
Washington
Zip
98466-3834
Phone Number
253-830-6242
Fax Number
person
Provider Business Mailing Address Details
Address
7610 40Th St W Ste 300
City
University Place
State
Washington
Zip
98466-3834
Phone Number
253-830-6242
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
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Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
CG60475423 (Washington)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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