Provider Demographics
NPI:1134718851
Name:SALAZAR, JAMES D (ARNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 LAKE TAPPS PKWY SE
Mailing Address - Street 2:STE.F104 BOX 150
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092
Mailing Address - Country:US
Mailing Address - Phone:360-255-1177
Mailing Address - Fax:
Practice Address - Street 1:522 W RIVERSIDE AVE STE N
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0580
Practice Address - Country:US
Practice Address - Phone:206-651-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP611341882084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61134188OtherWASHINGTON STATE ARNP LICENSE NUMBER
WA2020115886OtherANCC CERTIFICATION NUMBER