Individual
JESSICA PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO 60904317
Contact information
Practice address
3300 ROOSEVELT AVE, YAKIMA, WA 98902-6344
(509) 571-1455
(509) 469-9285
Mailing address
PO BOX 2849, YAKIMA, WA 98907-2849
(509) 248-1800
(509) 576-3050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60904317
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0755984
—
WA
Enumeration date
07/05/2019
Last updated
07/05/2019
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