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General NPI Number Information
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NPI Number | 1326482936
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Entity Type | Individual
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Provider Name | MILVIA BARENICE PACHECO SALVATIERRA MA60320887
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Gender | Female
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 15245 INTERNATIONAL BLVD STE 210
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City | SEATAC
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State | WA
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Zip | 98188-2233
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Country | US
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Telephone | 206-923-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 9456 18TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98106-2716
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Country | US
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Telephone | 206-852-7456
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | MA60320887
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License Number State | WA
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