Healthcare Provider Details

I. General information

NPI: 1851669337
Provider Name (Legal Business Name): DACIA KAY MURILLO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W 7TH AVE SUITE 420
SPOKANE WA
99204-2349
US

IV. Provider business mailing address

3709 N CAMPBELL AVE STE 201
TUCSON AZ
85719-1563
US

V. Phone/Fax

Practice location:
  • Phone: 509-626-9440
  • Fax:
Mailing address:
  • Phone: 866-747-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60268278
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: