Individual
PAUL VAN WYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 952-9838
Mailing address
PO BOX 1712, ZILLAH, WA 98953-1712
(509) 952-9838
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG60516729
WA
Other
Enumeration date
01/07/2015
Last updated
09/28/2016
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