Healthcare Provider Details

I. General information

NPI: 1750704219
Provider Name (Legal Business Name): CARMINA ZAVALA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14405 SE 36TH ST STE 300
BELLEVUE WA
98006-1588
US

IV. Provider business mailing address

100 N HOWARD ST STE R
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 626-975-8243
  • Fax:
Mailing address:
  • Phone: 626-975-8243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.61631547
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: