Provider Demographics
NPI:1437762598
Name:LIZARDI LUGO, MIRIAM R (MEDICAL INTERPRETER)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:R
Last Name:LIZARDI LUGO
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 1:224 197TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8434
Mailing Address - Country:US
Mailing Address - Phone:206-290-8560
Mailing Address - Fax:
Practice Address - Street 1:224 197TH STREET CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8434
Practice Address - Country:US
Practice Address - Phone:206-290-8560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC11587171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter