Provider Demographics
NPI:1548971773
Name:VARGAS, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MSW, LSWAIC
Mailing Address - Street 1:435 W BELL ST STE B
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-2916
Mailing Address - Country:US
Mailing Address - Phone:360-809-7774
Mailing Address - Fax:
Practice Address - Street 1:6611 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-8949
Practice Address - Country:US
Practice Address - Phone:509-885-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health