Provider Demographics
NPI:1750774568
Name:PANGGA, ESTHER QUEZADA (RN)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:QUEZADA
Last Name:PANGGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 S 296TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-3010
Mailing Address - Country:US
Mailing Address - Phone:239-297-1684
Mailing Address - Fax:239-694-4390
Practice Address - Street 1:6107 S 296TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-3010
Practice Address - Country:US
Practice Address - Phone:239-297-1684
Practice Address - Fax:239-694-4390
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9291325163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health