# WILD ROSE CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275809550
- **Authorized official:** REBEKAH PIERSON ARNP, CNM (PRESIDENT)
- **Authorized official phone:** (509) 460-4823

## Contact information

- **Practice address:** 711 S AUBURN ST STE P, KENNEWICK, WA 99336-5665
- **Practice address phone:** (509) 460-4823
- **Practice address fax:** (509) 460-4833
- **Mailing address:** PO BOX 6762, KENNEWICK, WA 99336-0640
- **Mailing address phone:** (509) 460-4823
- **Mailing address fax:** (509) 460-4833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | AP30003677 | WA | — |
| 363LW0102X | Women's Health Nurse Practitioner | AP30003677 | WA | — |
| 367A00000X | Advanced Practice Midwife | AP30003677 | WA | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012