Provider Demographics
NPI:1083197768
Name:MANDRAGON, KARINA VALHALLA (PA-C)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:VALHALLA
Last Name:MANDRAGON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:VALHALLA
Other - Last Name:CAPREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31001-4114
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-4114
Mailing Address - Country:US
Mailing Address - Phone:509-944-8920
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:212 E CENTRAL AVE STE 245
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6289
Practice Address - Country:US
Practice Address - Phone:509-489-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant