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Individual

MS. IOLY TABITA LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP/ARNP

Contact information

Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60785848
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1164784167
WA
05
171037
OR
01
AP60785848
LIC
WA
Enumeration date
06/14/2012
Last updated
05/20/2019
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