MEDICARE: DIODIS ESPINOSA FERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN70043140	WA

General Provider Information

NPI Number	:	1063345999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIODIS ESPINOSA FERNANDEZ

Provider Business Mailing Address
First Line	:	5700 NE 82ND AVE UNIT L54
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98662-9432
Country	:	US
Telephone Number	:	503-572-8301
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 NE 82ND AVE UNIT L54
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98662-9432
Country	:	US
Telephone Number	:	503-572-8301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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