Provider Demographics
NPI:1285207381
Name:ANGUIANO - ALVAREZ, BRENDA J
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:J
Last Name:ANGUIANO - ALVAREZ
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 1:402 W. MAPLE AVE
Mailing Address - Street 2:UNIT 37
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944
Mailing Address - Country:US
Mailing Address - Phone:509-305-6128
Mailing Address - Fax:
Practice Address - Street 1:402 W. MAPLE AVE
Practice Address - Street 2:UNIT 37
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944
Practice Address - Country:US
Practice Address - Phone:509-305-6128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC56477171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter