Healthcare Provider Details

I. General information

NPI: 1255229100
Provider Name (Legal Business Name): ALEJANDRA ELIZONDO DNP PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7011 W CANAL DR
KENNEWICK WA
99336-7687
US

IV. Provider business mailing address

3017 ROAD 56
PASCO WA
99301-2391
US

V. Phone/Fax

Practice location:
  • Phone: 509-735-6446
  • Fax:
Mailing address:
  • Phone: 509-975-2501
  • Fax: 509-463-4563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3481504
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number70010465
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: