Provider Demographics
NPI:1922863422
Name:ALARCON DIAZ, GLENDA MARISOL
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:MARISOL
Last Name:ALARCON DIAZ
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 1:1416 GIBSON RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5519
Mailing Address - Country:US
Mailing Address - Phone:425-532-8853
Mailing Address - Fax:
Practice Address - Street 1:1416 GIBSON RD UNIT B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5519
Practice Address - Country:US
Practice Address - Phone:425-532-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide