Provider Demographics
NPI:1245841006
Name:ESCOTO, LIDIA C
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:C
Last Name:ESCOTO
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 1:9432 5TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-3006
Mailing Address - Country:US
Mailing Address - Phone:206-707-3037
Mailing Address - Fax:
Practice Address - Street 1:9432 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-3006
Practice Address - Country:US
Practice Address - Phone:206-707-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WATC4291171R00000X
WAMC55079171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter