Organization
YOUGLYCEMIC DIABETES TREATMENT & PREVENTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA PETRIE (OWNER)
(509) 248-6414
Entity
Organization
Contact information
Practice address
3902 CREEKSIDE LOOP, SUITE 105, YAKIMA, WA 98902-4876
(509) 248-6414
(509) 248-6408
Mailing address
2103 S 54TH AVE, YAKIMA, WA 98903-2412
(509) 248-6414
(509) 248-6408
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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