1225237514 NPI number — JOAQUIN V. PEREZ

Table of content: (NPI 1225237514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225237514 NPI number — JOAQUIN V. PEREZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOAQUIN V. PEREZ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JOAQUIN V. PEREZ
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225237514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4333 12TH AVE NE # 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98105-5906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-632-7623
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4333 12TH AVE NE # 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105-5906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-632-7623
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
JOAQUIN
Authorized Official Middle Name:
V
Authorized Official Title or Position:
LANGUAGE INTERPRETER
Authorized Official Telephone Number:
206-632-7623

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  005107 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8269391 . This is a "PROVIDER #" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".