Active NPI 1477704559 Individual Practitioner Female Practitioner

Jennifer Martin , PA-C

Physician Assistant • Yakima, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jennifer Martin, PA-C is a certified Physician Assistant practicing in Yakima, WA. With approximately 18 years of clinical experience since completing medical education in 2008, Jennifer Martin delivers high-quality medical care to the local community at 1607 CREEKSIDE LOOP STE 140.

Jennifer Martin is affiliated with Integrative Dermatology and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1607 Creekside Loop Ste 140

Yakima, WA 989024882

Telephone 5099699076

Associated Practice Facility / Clinic

🏢 Integrative Dermatology Facility NPI 1891513651

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Yakima, WA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

18 Yrs +5.6 yrs vs City Avg

City Avg: 12.4 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

61 Specialists

Practicing in Yakima, WA (3774 Statewide)

Telehealth Adoption Rate

14.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

42.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Martin (18 Years) 18 Yrs

Yakima Specialty Average (12.4 Years) 12.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,501	279	$9.52	$5.92
99213 Established patient office or other outpatient visit, typically 15 minutes	1,308	807	$135.66	$79.51
17000 Destruction of skin growth	564	403	$99.60	$43.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	517	378	$173.88	$111.74
17110 Destruction of up to 14 skin growths	396	333	$169.73	$93.72
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	146	124	$177.04	$91.54
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	117	96	$184.80	$96.57
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	87	77	$212.06	$115.62
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	73	64	$172.40	$66.19
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	55	47	$179.82	$95.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$163.75	$97.56
17004 Destruction of precancer skin growth, 15 or more growths	52	41	$220.27	$148.02
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	41	39	$152.31	$77.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	37	37	$232.48	$146.05
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	34	34	$168.95	$119.19
11104 Punch biopsy, first skin growth	32	32	$196.39	$111.46
17111 Destruction of skin growth, 15 or more growths	18	16	$197.72	$118.86
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$173.40	$121.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,568	441	$7.28	$5.88
99213 Established patient office or other outpatient visit, typically 15 minutes	1,061	722	$94.75	$77.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	871	621	$138.82	$109.65
17000 Destruction of skin growth	817	592	$72.78	$43.29
17110 Destruction of up to 14 skin growths	494	409	$123.79	$89.90
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	156	132	$133.15	$94.93
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	133	110	$148.54	$110.52
17004 Destruction of precancer skin growth, 15 or more growths	132	95	$180.13	$148.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	129	129	$119.05	$96.32
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	126	126	$175.43	$142.90
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	125	110	$124.24	$90.42
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	69	60	$155.88	$111.80
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	68	63	$109.51	$70.40
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	65	60	$138.67	$101.62
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	49	44	$113.89	$73.22
11104 Punch biopsy, first skin growth	31	30	$137.69	$108.98
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	24	23	$143.52	$117.41
17111 Destruction of skin growth, 15 or more growths	23	21	$142.52	$116.55
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	22	22	$161.22	$137.44
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	14	13	$349.80	$299.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	7,602	39	$1.64	$1.58
17003 Destruction of precancer skin growth, 2-14 growths	2,569	460	$7.46	$5.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,530	980	$135.97	$110.05
17000 Destruction of skin growth	888	648	$73.15	$42.34
17110 Destruction of up to 14 skin growths	599	504	$125.39	$89.28
99213 Established patient office or other outpatient visit, typically 15 minutes	542	456	$101.43	$77.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	222	222	$180.58	$142.18
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	201	157	$134.74	$93.86
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	160	140	$130.33	$85.71
17004 Destruction of precancer skin growth, 15 or more growths	144	105	$185.73	$148.04
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	141	118	$148.73	$111.30
11104 Punch biopsy, first skin growth	98	92	$137.13	$109.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	94	94	$122.70	$94.60
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	91	82	$111.11	$62.01
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	71	66	$136.83	$93.74
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	65	58	$159.22	$114.17
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	51	48	$364.10	$304.81
96574 Application of light with debridement to destroy precancer skin growth	40	39	$312.65	$254.31
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	37	32	$111.51	$69.61
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	32	32	$223.90	$180.16
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	32	30	$171.51	$133.16
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	26	23	$157.36	$115.31
11102 Tangential biopsy of single skin lesion	18	18	$106.05	$80.02
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	14	12	$173.81	$112.05
11105 Punch biopsy, each additional skin growth	12	11	$66.55	$49.55
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	11	11	$172.68	$129.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	16,400	66	$2.98	$1.55
17003 Destruction of precancer skin growth, 2-14 growths	2,045	466	$15.29	$5.75
99213 Established patient office or other outpatient visit, typically 15 minutes	1,903	1,147	$217.90	$78.78
17000 Destruction of skin growth	727	582	$155.30	$50.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	537	413	$291.86	$112.12
17110 Destruction of up to 14 skin growths	532	454	$276.02	$95.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	277	277	$263.35	$96.62
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	228	194	$275.23	$86.83
17004 Destruction of precancer skin growth, 15 or more growths	207	132	$415.53	$145.96
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	191	147	$267.33	$92.82
11104 Punch biopsy, first skin growth	164	156	$293.13	$114.29
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	162	141	$322.49	$113.17
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	122	114	$222.77	$71.46
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	105	22	$2.40	$1.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	100	92	$126.73	$48.51
96574 Application of light with debridement to destroy precancer skin growth	82	66	$695.57	$257.62
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	78	71	$289.28	$100.25
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	74	63	$316.68	$119.98
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	62	57	$224.06	$76.61
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	62	62	$359.62	$145.33
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	37	32	$318.91	$181.48
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	35	34	$382.17	$141.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	31	19	$28.20	$12.34
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	29	23	$367.70	$117.16
11105 Punch biopsy, each additional skin growth	27	26	$114.52	$52.48
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	22	19	$389.13	$117.55
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	17	15	$787.73	$311.69
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$122.85	$63.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	10,400	44	$1.63	$1.45
17003 Destruction of precancer skin growth, 2-14 growths	1,366	328	$18.22	$5.31
99213 Established patient office or other outpatient visit, typically 15 minutes	829	576	$225.68	$64.61
17000 Destruction of skin growth	423	380	$197.35	$56.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	327	306	$138.39	$39.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	289	275	$329.36	$94.83
17110 Destruction of up to 14 skin growths	264	246	$342.18	$98.39
11102 Tangential biopsy of single skin lesion	259	218	$301.52	$86.88
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	188	42	$4.33	$1.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	134	134	$315.26	$93.44
11104 Punch biopsy, first skin growth	121	118	$380.21	$110.31
99202 New patient office or other outpatient visit, typically 20 minutes	99	99	$229.08	$66.17
17004 Destruction of precancer skin growth, 15 or more growths	91	84	$483.96	$138.31
11103 Biopsy of related skin growth, each additional growth	63	51	$160.02	$46.81
96574 Application of light with debridement to destroy precancer skin growth	52	44	$812.25	$232.38
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	50	47	$357.60	$92.35
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	42	38	$309.18	$76.04
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	41	38	$375.00	$99.77
11900 Injection into skin growth, 1-7 growths	33	20	$169.23	$40.36
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	32	28	$43.41	$12.41
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	29	29	$380.40	$109.23
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	28	27	$423.63	$115.12
99441 Telephone medical discussion with physician, 5-10 minutes	26	26	$138.60	$39.78
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	23	22	$324.93	$77.07
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	22	19	$438.48	$124.99
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	22	22	$493.37	$144.13
69100 Biopsy of ear	21	20	$302.79	$78.13
11105 Punch biopsy, each additional skin growth	13	13	$179.65	$53.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	14,200	62	$1.63	$1.40
17003 Destruction of precancer skin growth, 2-14 growths	1,057	200	$8.66	$4.89
99213 Established patient office or other outpatient visit, typically 15 minutes	853	452	$113.37	$63.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	456	358	$165.77	$93.35
17000 Destruction of skin growth	347	263	$100.28	$52.72
11102 Tangential biopsy of single skin lesion	316	258	$152.10	$83.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	195	195	$165.03	$93.07
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	193	34	$2.42	$1.58
17110 Destruction of up to 14 skin growths	138	124	$170.12	$94.88
11104 Punch biopsy, first skin growth	137	132	$191.24	$108.22
96574 Application of light with debridement to destroy precancer skin growth	72	63	$395.34	$223.74
11103 Biopsy of related skin growth, each additional growth	58	53	$82.01	$46.40
99202 New patient office or other outpatient visit, typically 20 minutes	57	57	$116.48	$65.35
17004 Destruction of precancer skin growth, 15 or more growths	53	41	$233.63	$132.21
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	48	45	$222.90	$126.13
69100 Biopsy of ear	30	28	$151.35	$72.82
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	24	22	$25.53	$14.45
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	23	21	$275.60	$152.55
11900 Injection into skin growth, 1-7 growths	19	14	$83.45	$41.37
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	17	16	$253.02	$138.97
11105 Punch biopsy, each additional skin growth	15	14	$100.19	$53.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$68.90	$38.98
17280 Destruction of malignant growth (0.5 centimeters or less) of face, ears, eyelids, nose, lips, or mouth	12	12	$215.19	$121.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	9,200	44	$1.63	$1.44
17003 Destruction of precancer skin growth, 2-14 growths	1,766	305	$8.95	$4.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	800	506	$162.68	$89.04
17000 Destruction of skin growth	600	412	$111.44	$42.04
99213 Established patient office or other outpatient visit, typically 15 minutes	479	279	$110.84	$60.13
11100 Biopsy of single growth of skin and/or tissue	425	336	$161.48	$80.29
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	344	56	$10.77	$1.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	285	285	$163.62	$88.99
17110 Destruction of up to 14 skin growths	256	218	$172.23	$91.69
11101 Biopsy of each additional growth of skin and/or tissue	80	64	$49.61	$27.20
17004 Destruction of precancer skin growth, 15 or more growths	73	48	$241.60	$121.05
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	44	35	$35.47	$17.11
96574 Application of light with debridement to destroy precancer skin growth	43	41	$368.13	$204.31
11900 Injection into skin growth, 1-7 growths	39	22	$86.23	$41.32
69100 Biopsy of ear	31	28	$155.58	$70.80
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	24	21	$222.55	$113.13
99202 New patient office or other outpatient visit, typically 20 minutes	18	18	$113.72	$62.28
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	15	15	$252.05	$127.60

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,134	342	$10.21	$4.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,031	609	$160.23	$88.07
11100 Biopsy of single growth of skin and/or tissue	701	501	$159.72	$79.10
17000 Destruction of skin growth	578	388	$125.02	$38.10
99213 Established patient office or other outpatient visit, typically 15 minutes	360	221	$109.20	$60.17
11101 Biopsy of each additional growth of skin and/or tissue	286	189	$48.99	$26.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	269	269	$162.28	$88.56
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	224	44	$21.82	$1.81
17110 Destruction of up to 14 skin growths	216	183	$171.56	$90.20
17004 Destruction of precancer skin growth, 15 or more growths	198	123	$259.23	$122.07
69100 Biopsy of ear	57	53	$155.64	$58.88
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	44	38	$38.78	$21.32
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	31	28	$221.47	$115.19
11900 Injection into skin growth, 1-7 growths	22	11	$85.22	$42.04
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$111.76	$58.83
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	17	$268.42	$132.91

Medical Specialties & State Licenses

CMS Verified: 2024-10-31

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA60218759

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License CA 19963

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License CA 19963

Definition to come...

Hospital & Practice Group Affiliations

Integrative Dermatology

1607 Creekside Loop, Yakima, WA 989024882

Phone: 5097941434

Secondary Practice Locations

3911 Castlevale Rd Ste 301

Yakima, WA 989027807

Phone: 5099667899

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Jeffrey Vantroba , PA-C

Physician Assistant - Medical

NPI 1669493516

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location October 31, 2024

Registered at 1607 CREEKSIDE LOOP STE 140, YAKIMA, WA 989024882 (Tel: 5099699076)

📍

Updated Business Mailing Address October 31, 2024

Registered at 1607 CREEKSIDE LOOP STE 140, YAKIMA, WA 989024882 (Tel: 5099699076)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2024

Physician Assistant (License #PA60218759 in WA)

📍

Updated Practice Location December 31, 2020

Registered at 3911 CASTLEVALE RD STE 301, YAKIMA, WA 989027807 (Tel: 5099667899)

✅

NPI Profile Active November 14, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location November 14, 2016

Registered at 602 E. NOB HILL BLVD., YAKIMA, WA 989013534 (Tel: 5092483334)

📍

Updated Business Mailing Address November 14, 2016

Registered at 3911 CASTLEVALE RD, STE 301, YAKIMA, WA 989027807 (Tel: 9095586641)

👤

Provider Name / Credentials Updated November 14, 2016

Recorded as JENNIFER MARTIN, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2016

Physician Assistant (License #19963 in CA)

🟢

Initial NPI Registration & Enumeration October 07, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477704559

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 07, 2008

Last Update: October 31, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1607 Creekside Loop Ste 140

Yakima, WA 989024882

Phone: 5099699076

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

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