Individual
DESTINY TIERRA NOEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 W 1ST AVE, TOPPENISH, WA 98948-1564
(509) 865-5600
(509) 865-5783
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-0757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2650
WV
363A00000X
Physician Assistant
Primary
PA61366379
WA
Other
Enumeration date
05/06/2022
Last updated
12/27/2022
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