Individual
SUSAN KELLY VANTUINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 N PEARL ST, ELLENSBURG, WA 98926-2938
(509) 925-9861
Mailing address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 575-4084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP0005032
WA
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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