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General NPI Number Information
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NPI Number | 1831906452
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Entity Type | Individual
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Provider Name | JANEL LYN MEZA IDHS
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 1519 ALASKAN WAY S
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City | SEATTLE
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State | WA
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Zip | 98134-1102
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Country | US
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Telephone | 830-719-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 15912 E SHORE DR
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City | LYNNWOOD
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State | WA
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Zip | 98087-6626
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Country | US
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Telephone | 830-719-9933
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number | 40644718
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License Number State | TX
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