Individual
JESSICA DI NIZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1300 N 1ST ST, YAKIMA, WA 98901
(509) 248-4510
Mailing address
1101 SAINT HILAIRE RD, YAKIMA, WA 98901-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
005296
AZ
207Q00000X
Family Medicine Physician
2021029615
MO
207Q00000X
Family Medicine Physician
Primary
60784868
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2096345
—
WA
05
—
509956
—
AZ
01
—
Z133563
MEDICARE PTAN
AZ
Enumeration date
04/02/2008
Last updated
02/07/2023
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