Provider Demographics
NPI:1730813676
Name:MARTINEZ GONZALEZ, KAREN EUNICE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:EUNICE
Last Name:MARTINEZ GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 108TH ST. CT E
Mailing Address - Street 2:UNIT 104
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445
Mailing Address - Country:US
Mailing Address - Phone:253-961-2361
Mailing Address - Fax:
Practice Address - Street 1:5915 ORCHARD ST. W
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467
Practice Address - Country:US
Practice Address - Phone:253-345-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst