Provider Demographics
NPI:1548539208
Name:SABORIO-RANGEL, PERLA ESTEFANIA
Entity type:Individual
Prefix:MS
First Name:PERLA
Middle Name:ESTEFANIA
Last Name:SABORIO-RANGEL
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 1:23128 SE 436 ST
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022
Mailing Address - Country:US
Mailing Address - Phone:253-315-9548
Mailing Address - Fax:
Practice Address - Street 1:21157 STATE ROUTE 410 E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-9067
Practice Address - Country:US
Practice Address - Phone:253-315-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60230255225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist