Individual
DR. VICTOR D IMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1514 W YAKIMA AVE, YAKIMA, WA 98902-2943
(509) 457-5387
(509) 457-6580
Mailing address
1514 W YAKIMA AVE, YAKIMA, WA 98902-2943
(509) 457-5387
(509) 457-6580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6921
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128266
LABOR AND INDUSTRIES
WA
01
—
5032222
DSHS
WA
01
—
9643
9643
WA
01
—
IM1280
BLUE SHIELD
WA
Enumeration date
10/03/2006
Last updated
07/22/2019
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