Healthcare Provider Details

I. General information

NPI: 1740125913
Provider Name (Legal Business Name): MERIDIANA VICTORIA MENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 FEDERAL AVE
EVERETT WA
98203-2132
US

IV. Provider business mailing address

13404 WOODS LAKE RD
MONROE WA
98272-9003
US

V. Phone/Fax

Practice location:
  • Phone: 360-419-7531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: