Provider Demographics
NPI:1316487333
Name:REIGSTAD, YVONNE R
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:R
Last Name:REIGSTAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 PERCH AVE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-5303
Mailing Address - Country:US
Mailing Address - Phone:509-750-7088
Mailing Address - Fax:
Practice Address - Street 1:618 S ALDER ST
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1760
Practice Address - Country:US
Practice Address - Phone:509-764-6677
Practice Address - Fax:509-764-6676
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician