Healthcare Provider Details

I. General information

NPI: 1275001273
Provider Name (Legal Business Name): DASHA RAQUEL FLAMEQVIST BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DASHA RAQUEL VALERIO BS

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

IV. Provider business mailing address

9330 59TH AVE SW
LAKEWOOD WA
98499-2858
US

V. Phone/Fax

Practice location:
  • Phone: 415-746-1940
  • Fax: 415-746-1941
Mailing address:
  • Phone: 253-620-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95371568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: