Healthcare Provider Details

I. General information

NPI: 1215623392
Provider Name (Legal Business Name): LUISA F CAJIAO DUARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 BROADWAY UNIT 446
SEATTLE WA
98122-5969
US

IV. Provider business mailing address

747 BROADWAY
SEATTLE WA
98122-4379
US

V. Phone/Fax

Practice location:
  • Phone: 206-889-7951
  • Fax:
Mailing address:
  • Phone: 385-288-1885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: