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Individual

INGRID Y VILLANUEVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
312 E 19TH AVE, KENNEWICK, WA 99337-5425
(509) 567-1012
Mailing address
312 E 19TH AVE, KENNEWICK, WA 99337-5425
(509) 567-1012

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171R00000X
171R00000X
WA
Enumeration date
03/07/2023
Last updated
03/07/2023
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