Individual
MIGUEL ANGEL BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CO61191490
Contact information
Practice address
2280 SR 821, YAKIMA, WA 98901-1017
(509) 307-6858
Mailing address
2280 SR 821, YAKIMA, WA 98901-1017
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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