Provider Demographics
NPI:1225237514
Name:JOAQUIN V. PEREZ
Entity Type:Organization
Organization Name:JOAQUIN V. PEREZ
Other - Org Name:JOAQUIN V. PEREZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LANGUAGE INTERPRETER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:V
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-632-7623
Mailing Address - Street 1:4333 12TH AVE NE # 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5906
Mailing Address - Country:US
Mailing Address - Phone:206-632-7623
Mailing Address - Fax:
Practice Address - Street 1:4333 12TH AVE NE # 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5906
Practice Address - Country:US
Practice Address - Phone:206-632-7623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA005107251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8269391OtherPROVIDER #
WA8269391OtherPROVIDER #