Provider Demographics
NPI:1851148043
Name:ESTACIO, CRYSTAL CAY
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:CAY
Last Name:ESTACIO
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 1:10510 248TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-6789
Mailing Address - Country:US
Mailing Address - Phone:253-385-0111
Mailing Address - Fax:
Practice Address - Street 1:10510 248TH STREET CT E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-6789
Practice Address - Country:US
Practice Address - Phone:253-385-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker