Individual
ESTRELLA VEGA VALENZUELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DA
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5250
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D161222067
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D161222067
DOH LICENSE
WA
Enumeration date
02/14/2022
Last updated
02/14/2022
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