Provider Demographics
NPI:1912297219
Name:CASTRO, SYLVIA GLADSTONE (ARNP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:GLADSTONE
Last Name:CASTRO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S GRADY WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3227
Mailing Address - Country:US
Mailing Address - Phone:206-823-1004
Mailing Address - Fax:206-309-3319
Practice Address - Street 1:707 S GRADY WAY STE 600
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:206-823-1004
Practice Address - Fax:206-309-3319
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60210183363LF0000X
WAAP 60210183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA203390Medicaid
WA2143055Medicaid
WAAP60210183OtherMEDICAL LICENSE
WARN00071163OtherMEDICAL LICENSE