Individual provider · NPI-1

Diego Alejandro Mendoza

Specialist/Technologist, Athletic Trainer · Yakima, WA

NPI number1083207104
StatusActive
Last updated in NPPESFeb 19, 2021

Details

NPI
1083207104
Entity type
Individual (NPI-1)
Name
Diego Alejandro Mendoza
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 19, 2021
Certification date
Feb 19, 2021
Last updated
Feb 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

603 S 20th Ave
Yakima, WA 98902-4225

Phone 509-823-6774

Mailing address

603 S 20th Ave
Yakima, WA 98902-4225

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