Provider Demographics
NPI:1821887399
Name:CANTOR VARGAS, JENNY FERNANDA
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:FERNANDA
Last Name:CANTOR VARGAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15305 NE 18TH ST APT G255
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4375
Mailing Address - Country:US
Mailing Address - Phone:425-625-9297
Mailing Address - Fax:
Practice Address - Street 1:15305 NE 18TH ST APT G255
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4375
Practice Address - Country:US
Practice Address - Phone:425-625-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor