Provider Demographics
NPI:1083220883
Name:PEREZ, LORENA (CRETIFIED SPANISH IN)
Entity Type:Individual
Prefix:MS
First Name:LORENA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CRETIFIED SPANISH IN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 MCLEAN RD #B
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273
Mailing Address - Country:US
Mailing Address - Phone:206-335-0058
Mailing Address - Fax:
Practice Address - Street 1:801 SAMISH WAY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229
Practice Address - Country:US
Practice Address - Phone:206-335-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC14659171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0365490OtherLABOR AND INDUSTRIES