Provider Demographics
NPI:1548992167
Name:SIU, ETHEL IVANIA
Entity type:Individual
Prefix:
First Name:ETHEL
Middle Name:IVANIA
Last Name:SIU
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 1:7655 S 132ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-4803
Mailing Address - Country:US
Mailing Address - Phone:206-310-9909
Mailing Address - Fax:
Practice Address - Street 1:7655 S 132ND ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-4803
Practice Address - Country:US
Practice Address - Phone:206-310-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty