Provider Demographics
NPI:1629542881
Name:PINEDA, CHELSEA JOYCE
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:JOYCE
Last Name:PINEDA
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 1:5202 88TH STREET CT SW APT C104
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-6489
Mailing Address - Country:US
Mailing Address - Phone:405-388-6037
Mailing Address - Fax:
Practice Address - Street 1:5202 88TH STREET CT SW APT C104
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-6489
Practice Address - Country:US
Practice Address - Phone:405-388-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60891039225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist