Provider Demographics
NPI:1588478192
Name:VELA-PEDRAZA, ADOLFO ANGEL
Entity type:Individual
Prefix:
First Name:ADOLFO
Middle Name:ANGEL
Last Name:VELA-PEDRAZA
Suffix:
Gender:M
Credentials:
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 32
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98858-0032
Mailing Address - Country:US
Mailing Address - Phone:509-881-5284
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 32
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:WA
Practice Address - Zip Code:98858-0032
Practice Address - Country:US
Practice Address - Phone:509-881-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor