Provider Demographics
NPI:1740140797
Name:SELENA DIAZ, PMHNP, PLLC
Entity type:Organization
Organization Name:SELENA DIAZ, PMHNP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, ARNP
Authorized Official - Phone:509-781-2554
Mailing Address - Street 1:1644 PLAZA WAY # 417
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4325
Mailing Address - Country:US
Mailing Address - Phone:509-781-2554
Mailing Address - Fax:888-979-6139
Practice Address - Street 1:991 SUNCREST TERRACE
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324
Practice Address - Country:US
Practice Address - Phone:509-781-2554
Practice Address - Fax:888-979-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty