Healthcare Provider Details

I. General information

NPI: 1538016696
Provider Name (Legal Business Name): VANESSA BEGAZO-ARAVENA PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 BATTERSBY AVE
ENUMCLAW WA
98022-3634
US

IV. Provider business mailing address

3201 13TH ST SW UNIT B
PUYALLUP WA
98373-6028
US

V. Phone/Fax

Practice location:
  • Phone: 360-802-8800
  • Fax:
Mailing address:
  • Phone: 253-533-1684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: