Provider Demographics
NPI:1396354643
Name:PITOT, MARITZA S
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:S
Last Name:PITOT
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 1:20119 74TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-5296
Mailing Address - Country:US
Mailing Address - Phone:100-000-0000
Mailing Address - Fax:
Practice Address - Street 1:20119 74TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-5296
Practice Address - Country:US
Practice Address - Phone:100-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter