Healthcare Provider Details

I. General information

NPI: 1720801061
Provider Name (Legal Business Name): JULISSA ZAVALA-MELENDREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12715 E MISSION AVE OPTIONAL
SPOKANE VALLEY WA
99201
US

IV. Provider business mailing address

44 E COZZA DR STE A-02
SPOKANE WA
99208-6514
US

V. Phone/Fax

Practice location:
  • Phone: 253-227-3802
  • Fax:
Mailing address:
  • Phone: 509-232-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61582049
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: