Provider Demographics
NPI:1710609359
Name:PRIETO, CLAUDIA NANCY
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:NANCY
Last Name:PRIETO
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 1:13322 62ND DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9411
Mailing Address - Country:US
Mailing Address - Phone:425-350-2657
Mailing Address - Fax:
Practice Address - Street 1:17809 SR 9 STE 8
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-6302
Practice Address - Country:US
Practice Address - Phone:425-350-2657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10953171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA10953OtherDSHS
WA10953Medicaid