Healthcare Provider Details

I. General information

NPI: 1477151025
Provider Name (Legal Business Name): GLENDA E MENDOZA MENDEZ RN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 ALDERWOOD MALL BLVD
LYNNWOOD WA
98036-6765
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 425-616-4100
  • Fax: 425-616-4115
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61487220
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: