Provider Demographics
NPI:1326730904
Name:LEON ALVARADO, ARACELI (ABO CERTIFICATION)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:LEON ALVARADO
Suffix:
Gender:F
Credentials:ABO CERTIFICATION
Other - Prefix:
Other - First Name:ARACELI
Other - Middle Name:
Other - Last Name:LEON ALVARADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NCLE CERTIFICATION
Mailing Address - Street 1:2675 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-2485
Mailing Address - Country:US
Mailing Address - Phone:509-839-4575
Mailing Address - Fax:509-839-4575
Practice Address - Street 1:2675 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-2485
Practice Address - Country:US
Practice Address - Phone:509-839-4575
Practice Address - Fax:509-839-4575
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADO60826830156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician