Individual
ELBA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 DIVISION ST, GRANDVIEW, WA 98930-1357
(509) 882-4260
(509) 882-6088
Mailing address
240 DIVISION ST, GRANDVIEW, WA 98930-1357
(509) 882-4260
(509) 882-6088
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60263508
WA
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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