Individual
JOSE V LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 575-4084
(509) 225-6313
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
(509) 575-4084
(575) 225-6313
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG60187838
WA
Other
Enumeration date
09/07/2010
Last updated
01/10/2012
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