Provider Demographics
NPI:1083299507
Name:PERESTREJO, OMAR GERARDO (CERT MEDICAL INTERP)
Entity Type:Individual
Prefix:MR
First Name:OMAR
Middle Name:GERARDO
Last Name:PERESTREJO
Suffix:
Gender:M
Credentials:CERT MEDICAL INTERP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28051 121ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-8525
Mailing Address - Country:US
Mailing Address - Phone:206-595-9254
Mailing Address - Fax:253-239-4263
Practice Address - Street 1:28051 121ST AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-8525
Practice Address - Country:US
Practice Address - Phone:206-595-9254
Practice Address - Fax:253-239-4263
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter