Provider Demographics
NPI:1659860278
Name:MOSHONTZ DE LA ROCHA, SARAH ILEEN (DOULA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ILEEN
Last Name:MOSHONTZ DE LA ROCHA
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:PATANJALI
Other - Middle Name:
Other - Last Name:DE LA ROCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10229 37TH PL SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1117
Mailing Address - Country:US
Mailing Address - Phone:818-395-4538
Mailing Address - Fax:
Practice Address - Street 1:747 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4379
Practice Address - Country:US
Practice Address - Phone:206-386-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty