Provider Demographics
NPI:1972228666
Name:RENDON, ESTEFANIA GUADALUPE (HUMAN SERVICES)
Entity Type:Individual
Prefix:
First Name:ESTEFANIA
Middle Name:GUADALUPE
Last Name:RENDON
Suffix:
Gender:F
Credentials:HUMAN SERVICES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE # 359797
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:120-674-4960
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE # 359797
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-9600
Practice Address - Fax:206-744-9920
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0OtherSTUDENT