Provider Demographics
NPI:1306428214
Name:MENDOZA, MARIA ROSA (INTERPRETER)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSA
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98850-0631
Mailing Address - Country:US
Mailing Address - Phone:509-699-1938
Mailing Address - Fax:
Practice Address - Street 1:27 ELGIN AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98850-5802
Practice Address - Country:US
Practice Address - Phone:509-699-1938
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 Licenses
StateLicense IDTaxonomies
WAMC7760171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter