Provider Demographics
NPI:1124882485
Name:BELANDRIA ESPINOSA, MARIEL
Entity type:Individual
Prefix:
First Name:MARIEL
Middle Name:
Last Name:BELANDRIA ESPINOSA
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 1:60151 COOPER DR APT A
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98433-1925
Mailing Address - Country:US
Mailing Address - Phone:931-561-0151
Mailing Address - Fax:
Practice Address - Street 1:1217 COOPER POINT RD SW STE 5
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-7206
Practice Address - Country:US
Practice Address - Phone:360-464-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician