Provider Demographics
NPI:1467064238
Name:LOPEZ, GENESIS GABRIELA (INTERPRETER)
Entity Type:Individual
Prefix:
First Name:GENESIS
Middle Name:GABRIELA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 E L ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-2436
Mailing Address - Country:US
Mailing Address - Phone:253-260-3543
Mailing Address - Fax:
Practice Address - Street 1:5908 E L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-2436
Practice Address - Country:US
Practice Address - Phone:253-260-3543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC18514171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter