Provider Demographics
NPI:1346067691
Name:HERRERA ESCOTO, ELA LINELVA
Entity type:Individual
Prefix:
First Name:ELA
Middle Name:LINELVA
Last Name:HERRERA ESCOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELA
Other - Middle Name:LINELVA
Other - Last Name:TINOCO HERRERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27442 149TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4365
Mailing Address - Country:US
Mailing Address - Phone:253-407-4429
Mailing Address - Fax:
Practice Address - Street 1:27442 149TH PL SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-4365
Practice Address - Country:US
Practice Address - Phone:253-407-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker