Provider Demographics
NPI:1407461650
Name:VIEYRA, LIZET TORRES
Entity Type:Individual
Prefix:
First Name:LIZET
Middle Name:TORRES
Last Name:VIEYRA
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 1:4005 S 262ND PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7145
Mailing Address - Country:US
Mailing Address - Phone:206-914-3922
Mailing Address - Fax:
Practice Address - Street 1:4005 S 262ND PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7145
Practice Address - Country:US
Practice Address - Phone:206-914-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC8120171R00000X
171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0418962OtherL&I PROVIDER NUMBER
WAMC8120OtherLICENSE
WAMC8120OtherINTERPRETER