Provider Demographics
NPI:1144822255
Name:SALGADO, PAOLA KRYSTAL
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:KRYSTAL
Last Name:SALGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAOLA
Other - Middle Name:KRYSTAL
Other - Last Name:SALGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5715 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6029
Mailing Address - Country:US
Mailing Address - Phone:509-619-4031
Mailing Address - Fax:
Practice Address - Street 1:5715 BELMONT DR
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-6029
Practice Address - Country:US
Practice Address - Phone:509-619-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC13954171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter