Provider Demographics
NPI:1841667631
Name:DELVALLE-LAVADA, ESTENYS (NP)
Entity type:Individual
Prefix:
First Name:ESTENYS
Middle Name:
Last Name:DELVALLE-LAVADA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ESTENYS
Other - Middle Name:
Other - Last Name:DELVALLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2313
Mailing Address - Country:US
Mailing Address - Phone:509-473-0305
Mailing Address - Fax:509-248-3644
Practice Address - Street 1:123 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2313
Practice Address - Country:US
Practice Address - Phone:509-473-0305
Practice Address - Fax:509-248-3644
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201504300NP-PP363LW0102X
WAAP60552068363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500690964Medicaid