Provider Demographics
NPI:1972357044
Name:ESTRADA, JOEL ALEJANDRO
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ALEJANDRO
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7306 142ND AVE E APT C
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-8228
Mailing Address - Country:US
Mailing Address - Phone:619-483-5090
Mailing Address - Fax:
Practice Address - Street 1:7306 142ND AVE E APT C
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-8228
Practice Address - Country:US
Practice Address - Phone:619-483-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter