Individual
SANDRA BENAVIDES-VAELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
915 WISCONSIN AVE, TIETON, WA 98947-9802
(509) 673-0044
(509) 452-5224
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 853-1082
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61315689
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2224325
—
WA
Enumeration date
09/01/2021
Last updated
07/17/2024
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