Provider Demographics
NPI:1407344385
Name:VALDEZ, EPIFANIA ANOR
Entity Type:Individual
Prefix:
First Name:EPIFANIA
Middle Name:ANOR
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 NE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4352
Mailing Address - Country:US
Mailing Address - Phone:720-660-5293
Mailing Address - Fax:877-436-3472
Practice Address - Street 1:1360 NE 8TH AVE
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4352
Practice Address - Country:US
Practice Address - Phone:720-660-5293
Practice Address - Fax:877-436-3472
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60023171163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse