Provider Demographics
NPI:1326657461
Name:ZUNIGA, JOUVANY JAHAZIEL
Entity Type:Individual
Prefix:
First Name:JOUVANY
Middle Name:JAHAZIEL
Last Name:ZUNIGA
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 1:3105 W RUBY ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3846
Mailing Address - Country:US
Mailing Address - Phone:509-302-0745
Mailing Address - Fax:
Practice Address - Street 1:3105 W RUBY ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3846
Practice Address - Country:US
Practice Address - Phone:509-302-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC16021171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter