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Individual

MANUEL YBANEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1016 TACOMA AVE, SUNNYSIDE, WA 98944-2263
(509) 837-7722
Mailing address
PO BOX 719, SUNNYSIDE, WA 98944-0719
(509) 837-1614

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G81484
CA
208600000X
Surgery Physician
Primary
MD60413221
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2035655
WA
05
269048900
FL
Enumeration date
10/07/2005
Last updated
02/10/2015
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