Individual
JUDITH LAVERNE CISNEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 S COOLIDGE ST., MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 764-0344
Mailing address
605 S COOLIDGE ST., MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 764-0344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201507736RN
OR
163W00000X
Registered Nurse
RN60696038
WA
171M00000X
Case Manager/Care Coordinator
Primary
RN60696038
WA
Other
Enumeration date
07/20/2018
Last updated
02/10/2020
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