Provider Demographics
NPI:1316554132
Name:CHINGOTTO, ESTELA
Entity Type:Individual
Prefix:
First Name:ESTELA
Middle Name:
Last Name:CHINGOTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W MERCER ST APT 208
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-5910
Mailing Address - Country:US
Mailing Address - Phone:206-992-5932
Mailing Address - Fax:
Practice Address - Street 1:17 W MERCER ST APT 208
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-5910
Practice Address - Country:US
Practice Address - Phone:206-992-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC12140171R00000X
WAMC5925171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter