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Individual

ANDREA MICHELLE PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
521 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3865
(509) 933-2400
(509) 933-4804
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60870697
WA
126800000X
Dental Assistant
D160434347
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0395484
LABOR AND INDUSTRIES
WA
05
2105044
WA
Enumeration date
06/22/2018
Last updated
09/10/2019
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