Provider Demographics
NPI:1588330989
Name:BUENO, SELINA RENEE (CM61106814)
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:RENEE
Last Name:BUENO
Suffix:
Gender:F
Credentials:CM61106814
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 GORDON RD APT 34
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-1753
Mailing Address - Country:US
Mailing Address - Phone:509-945-9651
Mailing Address - Fax:
Practice Address - Street 1:600 SUPERIOR LN
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1623
Practice Address - Country:US
Practice Address - Phone:509-853-4175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information