Provider Demographics
NPI:1003370271
Name:ALVARADO, AMANDA ROCIO
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ROCIO
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17331 122ND LN SE APT NN101
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6271
Mailing Address - Country:US
Mailing Address - Phone:773-512-9429
Mailing Address - Fax:
Practice Address - Street 1:17331 122ND LN SE APT NN101
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6271
Practice Address - Country:US
Practice Address - Phone:773-512-9429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL194010186227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified