Healthcare Provider Details

I. General information

NPI: 1225237514
Provider Name (Legal Business Name): JOAQUIN V. PEREZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 12TH AVE NE # 1
SEATTLE WA
98105-5906
US

IV. Provider business mailing address

4333 12TH AVE NE # 1
SEATTLE WA
98105-5906
US

V. Phone/Fax

Practice location:
  • Phone: 206-632-7623
  • Fax:
Mailing address:
  • Phone: 206-632-7623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number005107
License Number StateWA

VIII. Authorized Official

Name: MR. JOAQUIN V PEREZ
Title or Position: LANGUAGE INTERPRETER
Credential:
Phone: 206-632-7623