Provider Demographics
NPI:1033723457
Name:GIOVANNONI, LIGIA ALBA (CMI)
Entity Type:Individual
Prefix:
First Name:LIGIA
Middle Name:ALBA
Last Name:GIOVANNONI
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:LIGIA
Other - Middle Name:
Other - Last Name:GIOVANNONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMI
Mailing Address - Street 1:5814 17TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2512
Mailing Address - Country:US
Mailing Address - Phone:707-572-7902
Mailing Address - Fax:
Practice Address - Street 1:3205 S LUCILE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2247
Practice Address - Country:US
Practice Address - Phone:707-572-7902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA55840171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter