Provider Demographics
NPI:1326770702
Name:SARMIENTO MENDOZA, SILVIA ADRIANA (LMT)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:ADRIANA
Last Name:SARMIENTO MENDOZA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241874
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-1874
Mailing Address - Country:US
Mailing Address - Phone:907-720-4555
Mailing Address - Fax:
Practice Address - Street 1:2606 SPENARD RD # M
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2309
Practice Address - Country:US
Practice Address - Phone:907-279-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK195784225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist