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Individual

MS. ELIZABETH A GROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
717 FRUITVALE BLVD, YAKIMA, WA 98902-1465
(509) 966-0199
(509) 966-4266
Mailing address
717 FRUITVALE BLVD, YAKIMA, WA 98902-1465
(509) 966-0199
(509) 966-4266

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30006768
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0194525
LABOR AND INDUSTRIES
WA
01
8943771
CRIME VICTIMS
WA
01
9066GR
REGENCE
WA
05
9645060
WA
Enumeration date
11/13/2006
Last updated
08/29/2012
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