Individual
IDOLINA MALTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3911 CASTLEVALE RD, YAKIMA, WA 98902-7807
(509) 453-8231
(509) 453-0130
Mailing address
3911 CASTLEVALE RD, YAKIMA, WA 98902-7807
(509) 453-8231
(509) 453-0130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA10003511
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8329393
—
WA
Enumeration date
08/14/2006
Last updated
10/04/2007
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