Healthcare Provider Details

I. General information

NPI: 1801717376
Provider Name (Legal Business Name): SAMANTHA K ORELLANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 E MONTGOMERY AVE # 99207
SPOKANE WA
99207-2667
US

IV. Provider business mailing address

734 E MONTGOMERY AVE # 99207
SPOKANE WA
99207-2667
US

V. Phone/Fax

Practice location:
  • Phone: 509-724-9966
  • Fax:
Mailing address:
  • Phone: 509-724-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberWDL3Z9B33B
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: