Provider Demographics
NPI:1346856283
Name:CHAVEZ, JENNIFER KAREN (MEDICAL INTERPRETER)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAREN
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MEDICAL INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 IRA LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1639
Mailing Address - Country:US
Mailing Address - Phone:954-446-3126
Mailing Address - Fax:
Practice Address - Street 1:72 IRA LIGHT ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-1639
Practice Address - Country:US
Practice Address - Phone:954-446-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC54490171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0385402OtherLNI PROVIDER NUMBER