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Individual

DANIEL CRUZ MENDIOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTRL, CHT

Contact information

Practice address
615 LILLY RD NE STE 240, OLYMPIA, WA 98506-5117
(360) 413-3850
(360) 359-4726
Mailing address
615 LILLY RD NE STE 240, OLYMPIA, WA 98506-5117
(360) 413-3850
(360) 359-4726

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
OT00000867
WA
225XH1200X
Hand Occupational Therapist
Primary
OT00000867
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8341299
WA
Enumeration date
05/29/2007
Last updated
03/22/2022
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