Individual
DIANDRA ELIZABETH ULLOA-PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 KOALA DR, OMAK, WA 98841-9247
(509) 826-6191
Mailing address
PO BOX 685, OMAK, WA 98841-0685
(509) 861-8097
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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