Provider Demographics
NPI:1093515272
Name:PEHALOZA CAMACHO, ALONDRA
Entity type:Individual
Prefix:
First Name:ALONDRA
Middle Name:
Last Name:PEHALOZA CAMACHO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 W QUINAULT AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7630
Mailing Address - Country:US
Mailing Address - Phone:509-627-8578
Mailing Address - Fax:
Practice Address - Street 1:5804 W QUINAULT AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7630
Practice Address - Country:US
Practice Address - Phone:509-627-8578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter