Healthcare Provider Details

I. General information

NPI: 1831000983
Provider Name (Legal Business Name): ANJEL MARIE PEDROZA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRAGUE AVE
WALLA WALLA WA
99362-3900
US

IV. Provider business mailing address

800 SPRAGUE AVE STE 101
WALLA WALLA WA
99362-3900
US

V. Phone/Fax

Practice location:
  • Phone: 509-563-0719
  • Fax:
Mailing address:
  • Phone: 509-563-0719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.61567509
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberMASS.MA.61567509
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: