Provider Demographics
NPI:1750178232
Name:VAZQUEZ JOA, SABEL-AN PATRICIA (LMT)
Entity type:Individual
Prefix:
First Name:SABEL-AN
Middle Name:PATRICIA
Last Name:VAZQUEZ JOA
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9604 NE 130TH PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-2986
Mailing Address - Country:US
Mailing Address - Phone:360-936-1200
Mailing Address - Fax:360-936-1200
Practice Address - Street 1:9604 NE 130TH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-2986
Practice Address - Country:US
Practice Address - Phone:360-936-1200
Practice Address - Fax:360-936-1200
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28258225700000X
WAMA61658880225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist