Provider Demographics
NPI:1528017431
Name:CABRERA, MILAGROS T (RDH)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:T
Last Name:CABRERA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3364
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114-3364
Mailing Address - Country:US
Mailing Address - Phone:206-324-9360
Mailing Address - Fax:206-324-8910
Practice Address - Street 1:606 12TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2008
Practice Address - Country:US
Practice Address - Phone:206-324-9360
Practice Address - Fax:206-324-8910
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00005522124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5901731Medicaid