Provider Demographics
NPI:1316680473
Name:SANCHEZ, SANTIAGO DELUNA (MHT)
Entity type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:DELUNA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MHT
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:MARGARITA
Other - Last Name:DELUNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1216 MARTIN LUTHER KING JR WAY APT 406
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3992
Mailing Address - Country:US
Mailing Address - Phone:253-331-0580
Mailing Address - Fax:
Practice Address - Street 1:721 FAWCETT AVE STE 101
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5502
Practice Address - Country:US
Practice Address - Phone:253-331-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician