Healthcare Provider Details

I. General information

NPI: 1700749413
Provider Name (Legal Business Name): DANIA MERCEDES RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E PIONEER
PUYALLUP WA
98372-3265
US

IV. Provider business mailing address

PO BOX 607
ENUMCLAW WA
98022-0607
US

V. Phone/Fax

Practice location:
  • Phone: 253-434-0771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG70068563
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: