Most Relevant Information
Provider Data
| NPI Number: | 1003568031 |
| Provider Name: | SHAY MICHALE FUENTES |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/20/2022 |
| Last Updated: | 01/20/2022 |
Provider Practice Location
17715 88TH AVE NE
BOTHELL
WA
980111822
Practice Location Phone/Fax
| Phone: | 4257611542 |
| Fax: |
Provider Mailing Location
1425 S PUGET DR APT 304
RENTON
WA
980554329
Provider Mailing Phone/Fax
| Phone: | 4257611542 |
| Fax: |