Provider Demographics
NPI:1639825516
Name:GONZALEZ DELGADO, MARY B
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:GONZALEZ DELGADO
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 1:4119 E BLAINE ST APT 8
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3206
Mailing Address - Country:US
Mailing Address - Phone:206-387-3337
Mailing Address - Fax:
Practice Address - Street 1:4119 E BLAINE ST APT 8
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3206
Practice Address - Country:US
Practice Address - Phone:206-387-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter