Provider Demographics
NPI:1942036397
Name:PAREDES, YESSICA MARENCO
Entity type:Individual
Prefix:
First Name:YESSICA
Middle Name:MARENCO
Last Name:PAREDES
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 1:4300 NE SUNSET BLVD UNIT D8
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-4029
Mailing Address - Country:US
Mailing Address - Phone:206-883-0405
Mailing Address - Fax:
Practice Address - Street 1:13343 NE BEL RED RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2274
Practice Address - Country:US
Practice Address - Phone:425-679-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program