Individual
MRS. CHANTELLE ELIZABETH ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2618 S LYLE ST, KENNEWICK, WA 99337-7821
(505) 860-1359
Mailing address
2618 S LYLE ST, KENNEWICK, WA 99337-7821
(505) 860-1359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1142330
NCCPA
—
Enumeration date
07/17/2017
Last updated
07/21/2022
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