Provider Demographics
NPI:1699357590
Name:VELAZQUEZ ZURITA, STEFANY
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:VELAZQUEZ ZURITA
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 1:6604 OKLAHOMA DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7549
Mailing Address - Country:US
Mailing Address - Phone:360-980-0534
Mailing Address - Fax:
Practice Address - Street 1:2501 SE COLUMBIA WAY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-8045
Practice Address - Country:US
Practice Address - Phone:360-980-0534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter