Individual
LETICIA MARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 S 11TH AVE, YAKIMA, WA 98902-5444
(509) 901-7177
Mailing address
1411 S 11TH AVE, YAKIMA, WA 98902-5444
(509) 901-7177
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
MC55993
WA
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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