Provider Demographics
NPI:1679155501
Name:MARTINEZ-CARDOSO, ALEJANDRA (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:MARTINEZ-CARDOSO
Suffix:
Gender:
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 ROAD 44
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2667
Mailing Address - Country:US
Mailing Address - Phone:509-543-9820
Mailing Address - Fax:509-545-6275
Practice Address - Street 1:1608 ROAD 44
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-2667
Practice Address - Country:US
Practice Address - Phone:509-543-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61169567104100000X
WALW615232481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker