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Individual

YAJAIRA WALTERMIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDPT

Contact information

Practice address
1313 N 13TH AVE, WALLA WALLA, WA 99362-8817
(509) 525-3610
Mailing address
1313 N 13TH AVE, WALLA WALLA, WA 99362-8817
(509) 525-3610

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61145287
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077844
WA
Enumeration date
01/27/2022
Last updated
01/27/2022
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