Provider Demographics
NPI:1194231613
Name:DIAZ-JIMENEZ, ORLANDO UZIEL
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:UZIEL
Last Name:DIAZ-JIMENEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13660 W 6TH AVE APT B205
Mailing Address - Street 2:
Mailing Address - City:AIRWAY HEIGHTS
Mailing Address - State:WA
Mailing Address - Zip Code:99001-5179
Mailing Address - Country:US
Mailing Address - Phone:509-294-5875
Mailing Address - Fax:
Practice Address - Street 1:13660 W 6TH AVE APT B205
Practice Address - Street 2:
Practice Address - City:AIRWAY HEIGHTS
Practice Address - State:WA
Practice Address - Zip Code:99001-5179
Practice Address - Country:US
Practice Address - Phone:509-294-5875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist