Provider Demographics
NPI:1568348910
Name:MATTA, CINDY HA VO
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:HA VO
Last Name:MATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CINDY
Other - Middle Name:HA
Other - Last Name:VO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9720 S TACOMA WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4456
Mailing Address - Country:US
Mailing Address - Phone:253-503-3666
Mailing Address - Fax:
Practice Address - Street 1:9720 S TACOMA WAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4456
Practice Address - Country:US
Practice Address - Phone:253-503-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP61471387164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse