Provider Demographics
NPI:1780294272
Name:GUILLEN MENDOZA, MARIA ANGELICA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANGELICA
Last Name:GUILLEN MENDOZA
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 1:1462 SE CAMANO DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-7634
Mailing Address - Country:US
Mailing Address - Phone:253-389-5574
Mailing Address - Fax:
Practice Address - Street 1:1462 SE CAMANO DR
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-7634
Practice Address - Country:US
Practice Address - Phone:253-389-5574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter