Provider Demographics
NPI:1851275127
Name:DE LA PENA, ROMEO D (ND, PHD, REFLEXOLOGY)
Entity type:Individual
Prefix:
First Name:ROMEO
Middle Name:D
Last Name:DE LA PENA
Suffix:
Gender:M
Credentials:ND, PHD, REFLEXOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 PIERCE LN UNIT 23
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1375
Mailing Address - Country:US
Mailing Address - Phone:425-315-6587
Mailing Address - Fax:
Practice Address - Street 1:715 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-2020
Practice Address - Country:US
Practice Address - Phone:360-588-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60397199173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist