Provider Information for 1568979094
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JUNE EVELYN WEST
Sex: Female
NPI: 1568979094
Last Updated: 2023-03-02
Certification Date: 2023-03-02
Certification Date: 2023-03-02
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568979094 | ||||||||
| Enumeration Date | 2018-01-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 151 TOPPENISH, WA 98948-0151 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 2908 W VIOLA AVE YAKIMA, WA 98902-4938 United States Phone: 509-952-7084 | Fax: | ||||||||
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