Provider Demographics
NPI:1821713405
Name:REBOLLO, SANDRA (MEDICAL INTERPRETER)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:REBOLLO
Suffix:
Gender:F
Credentials:MEDICAL INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 BEAUCHENE RD
Mailing Address - Street 2:
Mailing Address - City:MOXEE
Mailing Address - State:WA
Mailing Address - Zip Code:98936-9734
Mailing Address - Country:US
Mailing Address - Phone:509-901-0226
Mailing Address - Fax:
Practice Address - Street 1:4809 BEAUCHENE RD
Practice Address - Street 2:
Practice Address - City:MOXEE
Practice Address - State:WA
Practice Address - Zip Code:98936-9734
Practice Address - Country:US
Practice Address - Phone:509-901-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604954932347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle