Healthcare Provider Details

I. General information

NPI: 1548826431
Provider Name (Legal Business Name): DIANA MARY ESPERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14812 117TH PL NE
KIRKLAND WA
98034-4639
US

IV. Provider business mailing address

14812 117TH PL NE
KIRKLAND WA
98034-4639
US

V. Phone/Fax

Practice location:
  • Phone: 206-271-4402
  • Fax:
Mailing address:
  • Phone: 206-271-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: