Healthcare Provider Details

I. General information

NPI: 1992174882
Provider Name (Legal Business Name): DAISY MITCHELLE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAISY MITCHELLE RODRIGUEZ

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 16TH AVE E
SEATTLE WA
98112-5212
US

IV. Provider business mailing address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

V. Phone/Fax

Practice location:
  • Phone: 206-901-2000
  • Fax:
Mailing address:
  • Phone: 206-901-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC61354562
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: