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General NPI Number Information
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NPI Number | 1629608922
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Entity Type | Individual
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Provider Name | ANDREA M.M. CERVANTES
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Gender | Female
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Dates
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Enumeration Date | 01/25/2020
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Last Update Date | 01/25/2020
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Provider Practice Location Address
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Address Line | 1857 140TH PL SE
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City | BELLEVUE
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State | WA
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Zip | 98007-6047
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Country | US
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Telephone | 425-528-3738
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 MADISON ST
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City | EVERETT
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State | WA
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Zip | 98203-5233
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Country | US
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Telephone | 425-528-3738
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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