Provider Demographics
NPI:1962766790
Name:PENA, CINDY ALDALI
Entity type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:ALDALI
Last Name:PENA
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 1:7435 159TH PL NE
Mailing Address - Street 2:G-141
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4336
Mailing Address - Country:US
Mailing Address - Phone:425-306-4677
Mailing Address - Fax:
Practice Address - Street 1:7435 159TH PL NE
Practice Address - Street 2:G-141
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4336
Practice Address - Country:US
Practice Address - Phone:425-306-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00066877183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician