Individual
TRACY LEEANN KENISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 S 11TH AVE STE 320, YAKIMA, WA 98902-3273
(509) 454-8888
(509) 453-0061
Mailing address
PO BOX 2309, YAKIMA, WA 98907-2309
(509) 454-8888
(509) 453-0061
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10005307
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1057024
—
WA
01
—
PA10005307
WA PA LICENSE
WA
Enumeration date
10/15/2007
Last updated
01/26/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us