Provider Demographics
NPI:1366618159
Name:CHAVEZ, REYNALDO (MSW)
Entity type:Individual
Prefix:
First Name:REYNALDO
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 PITCHER ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-3063
Mailing Address - Country:US
Mailing Address - Phone:509-457-8554
Mailing Address - Fax:509-225-4682
Practice Address - Street 1:917 PITCHER ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-3063
Practice Address - Country:US
Practice Address - Phone:509-457-8554
Practice Address - Fax:509-225-4682
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00033341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional