Individual
WENA LYNN DOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
319 S 11TH AVE, YAKIMA, WA 98902-3213
(509) 453-1420
(509) 453-1453
Mailing address
319 S 11TH AVE, YAKIMA, WA 98902-3213
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60315398
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 60315398
STATE LICENSE
WA
Enumeration date
07/22/2014
Last updated
07/22/2014
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