Individual
ROBERTA A BUUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
521 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3865
(509) 962-1414
(509) 962-1408
Mailing address
1806 W LINCOLN AVE, YAKIMA, WA 98902-2473
(509) 452-4520
(509) 452-5224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003677
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226463
L&I
WA
05
—
7118250
—
WA
Enumeration date
05/20/2006
Last updated
01/27/2011
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