Healthcare Provider Details

I. General information

NPI: 1962413641
Provider Name (Legal Business Name): MARIBEN CRISTINA C ESTRADA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 S CEDAR ST STE 300
TACOMA WA
98405-2318
US

IV. Provider business mailing address

2901 BRIDGEPORT WAY W
UNIVERSITY PLACE WA
98466-4614
US

V. Phone/Fax

Practice location:
  • Phone: 253-301-5280
  • Fax: 253-627-4608
Mailing address:
  • Phone: 253-534-7000
  • Fax: 253-534-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00042378
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD00042378
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: