Provider Demographics
NPI:1104534825
Name:GUERRERO, JULISSA
Entity type:Individual
Prefix:
First Name:JULISSA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULISSA
Other - Middle Name:
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEDICAL INTERPRETER
Mailing Address - Street 1:2902 RICHEY RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2300
Mailing Address - Country:US
Mailing Address - Phone:509-388-3485
Mailing Address - Fax:
Practice Address - Street 1:2902 RICHEY RD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2300
Practice Address - Country:US
Practice Address - Phone:509-388-3485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4149171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter