Individual
WARD A KAYUTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 575-4084
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
(509) 575-4084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
N160242045
WA
Other
Enumeration date
08/26/2011
Last updated
08/26/2011
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