Individual
ASHLEY NICOLE KOBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 FRANKLIN AVE, SUNNYSIDE, WA 98944
(509) 945-4397
Mailing address
408 W 11TH AVE, ELLENSBURG, WA 98926-2412
(509) 367-1148
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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