Provider Demographics
NPI:1578388393
Name:SANCHEZ MEJIA, VIRIDIANA
Entity type:Individual
Prefix:MRS
First Name:VIRIDIANA
Middle Name:
Last Name:SANCHEZ MEJIA
Suffix:
Gender:F
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 773
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98813-0773
Mailing Address - Country:US
Mailing Address - Phone:509-733-0129
Mailing Address - Fax:
Practice Address - Street 1:1400 TACOMA AVENUE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WA
Practice Address - Zip Code:98813
Practice Address - Country:US
Practice Address - Phone:509-686-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP615999992355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant