Provider Demographics
NPI:1942893334
Name:DELA PAZ PADILLA, MARIA THERESA DAVID
Entity Type:Individual
Prefix:
First Name:MARIA THERESA
Middle Name:DAVID
Last Name:DELA PAZ PADILLA
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 1:2219 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-5335
Mailing Address - Country:US
Mailing Address - Phone:909-680-5857
Mailing Address - Fax:
Practice Address - Street 1:2219 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5335
Practice Address - Country:US
Practice Address - Phone:909-680-5857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60311018163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse