| Doctor Name: | MRS. GINETTE MARIE DIDOMENICO |
| NPI Number: | 1558764233 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP60508368 |
| Business Practice Address: | 27715 Ne 20th Pl Carnation, WA - 980148211 |
| Business Phone Number: | 4252214657 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1162, CARNATION |
| State: | WA |
| Postal Code: | 980141162 |
| Phone Number: | 4252214657 |
| Fax Number: | |
| NPI Enumeration Date: | 10/08/2014 |
| NPI Last Update Date: | 06/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | AP60508368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |