Provider Information for 1760154066
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CESAR AUGUSTO BUSTAMANTE LMHCA
Sex: Male
NPI: 1760154066
Last Updated: 2024-12-27
Certification Date: 2024-12-27
Certification Date: 2024-12-27
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760154066 | ||||||||
| Enumeration Date | 2021-10-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3406 S GRAND BLVD APT 100 SPOKANE, WA 99203-2661 United States Phone: 509-570-8264 | Fax: | ||||||||
| Primary Practice Address | 3406 S GRAND BLVD APT 100 SPOKANE, WA 99203-2661 United States Phone: 509-570-8264 | Fax: | ||||||||
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