Individual
IRVIN MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5201 TIETON DR, YAKIMA, WA 98908-3485
(509) 965-7100
Mailing address
5201 TIETON DR STE C, YAKIMA, WA 98908-3485
(509) 965-7100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB60975512
WA
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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