Provider Demographics
NPI:1346933595
Name:PERAZA, KEYRA (CBS)
Entity Type:Individual
Prefix:
First Name:KEYRA
Middle Name:
Last Name:PERAZA
Suffix:
Gender:F
Credentials:CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 NE 139TH ST APT H69
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-2768
Mailing Address - Country:US
Mailing Address - Phone:954-496-0496
Mailing Address - Fax:
Practice Address - Street 1:2406 NE 139TH ST APT H69
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2768
Practice Address - Country:US
Practice Address - Phone:954-496-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN