Provider Demographics
NPI:1003337148
Name:VIGUERAS, VARINIA (PA-C)
Entity Type:Individual
Prefix:
First Name:VARINIA
Middle Name:
Last Name:VIGUERAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VARINIA
Other - Middle Name:
Other - Last Name:VIGUERAS ROBLES LINARES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6505 COMPTON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98513-6228
Mailing Address - Country:US
Mailing Address - Phone:253-232-2062
Mailing Address - Fax:
Practice Address - Street 1:4110 BRIARGATE PKWY STE 460
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7839
Practice Address - Country:US
Practice Address - Phone:719-364-6488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006271363A00000X
WAPA.PA.60772987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant