Provider Demographics
NPI:1093959017
Name:PRECIADO, ALONDRA (MA60058479)
Entity Type:Individual
Prefix:
First Name:ALONDRA
Middle Name:
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:MA60058479
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 W GRANDRIDGE BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7159
Mailing Address - Country:US
Mailing Address - Phone:509-783-1899
Mailing Address - Fax:509-783-1898
Practice Address - Street 1:8033 W GRANDRIDGE BLVD
Practice Address - Street 2:STE C
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7159
Practice Address - Country:US
Practice Address - Phone:509-783-1899
Practice Address - Fax:509-783-1898
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60058479225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist