MEDICARE: CARMINA ZAVALA PSYD

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	101YM0800X	Mental Health Counselor	MHCA.MC.61631547	WA

General Provider Information

NPI Number	:	1750704219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMINA ZAVALA PSYD

Provider Business Mailing Address
First Line	:	100 N HOWARD ST STE R
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0508
Country	:	US
Telephone Number	:	626-975-8243
Fax Number	:

Provider Business Practice Location Address
First Line	:	14405 SE 36TH ST STE 300
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1588
Country	:	US
Telephone Number	:	626-975-8243
Fax Number	:

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

Provider Enumeration Date	:	02/03/2014
Last Update Date	:	05/08/2026

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