Basic Information
| Provider Information | |||||||||
| NPI: | 1740581727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | ISABEL | ||||||||
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| Credential: | LMP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SANCHEZ TERAN | ||||||||
| OtherFirstName: | ANA | ||||||||
| OtherMiddleName: | ISABEL | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1127 WALNUT ST | ||||||||
| Address2: | APT. M1 | ||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983104614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605505759 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4060 WHEATON WAY | ||||||||
| Address2: | SUITE C | ||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983103500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604798477 | ||||||||
| FaxNumber: | 3604798417 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2010 | ||||||||
| LastUpdateDate: | 02/08/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA60192665 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.