Basic Information
Provider Information
NPI: 1770118291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALAZAR MONK
FirstName: LETITIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
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Mailing Information
Address1: 1200 12TH AVE S STE 901
Address2:  
City: SEATTLE
State: WA
PostalCode: 981442712
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4400 37TH AVE S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981181609
CountryCode: US
TelephoneNumber: 2064616957
FaxNumber: 2064617810
Other Information
ProviderEnumerationDate: 03/04/2020
LastUpdateDate: 08/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X60991099WAN Nursing Service ProvidersRegistered Nurse 
367A00000XAP61298435WAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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