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General NPI Number Information
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NPI Number | 1265944326
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Entity Type | Individual
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Provider Name | ERLINDA VERGARA
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Gender | Female
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | BLDG 2103 NORTH DIVISION
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City | TACOMA
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State | WA
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Zip | 98433
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Country | US
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Telephone | 253-966-7801
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Fax |
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Provider Business Mailing Address
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Address Line | BLDG 2103P NORTH DIVISION ST.
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City | JBLM
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State | WA
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Zip | 98433
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Country | US
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Telephone | 253-967-3416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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