Provider Demographics
NPI:1659805315
Name:PUNCHES, VANESSA (ATC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PUNCHES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 NE 43RD CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-6492
Mailing Address - Country:US
Mailing Address - Phone:801-205-8149
Mailing Address - Fax:
Practice Address - Street 1:12810 NE 43RD CIR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-6492
Practice Address - Country:US
Practice Address - Phone:801-205-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer