Provider Demographics
NPI:1215540174
Name:GONZALEZ, SILVIA ESMERALDA (MC56506)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:ESMERALDA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MC56506
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 N EDISON ST APT C207
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1567
Mailing Address - Country:US
Mailing Address - Phone:509-834-0408
Mailing Address - Fax:
Practice Address - Street 1:1548 N EDISON ST APT C207
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1567
Practice Address - Country:US
Practice Address - Phone:509-834-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter