Healthcare Provider Details

I. General information

NPI: 1548183494
Provider Name (Legal Business Name): MS. ANASTACIA DEGUZMAN SIJERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 BRAEMAR DR
EDMONDS WA
98026-5136
US

IV. Provider business mailing address

16607 41ST STREET, PL. W.
LYNNWOOD WA
98037
US

V. Phone/Fax

Practice location:
  • Phone: 206-372-6452
  • Fax:
Mailing address:
  • Phone: 206-372-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number757762
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: