Individual
MAIRA VIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1090 W BETZ RD APT 18106, CHENEY, WA 99004-5267
(509) 551-0602
Mailing address
1090 W BETZ RD APT 18106, CHENEY, WA 99004-5267
(509) 551-0602
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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