Provider Demographics
NPI:1598851784
Name:GARZA, ERICA (ARNP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 MEMORIAL ST
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1524
Mailing Address - Country:US
Mailing Address - Phone:509-786-2222
Mailing Address - Fax:509-786-6612
Practice Address - Street 1:1003 WALLACE WAY
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-8805
Practice Address - Country:US
Practice Address - Phone:509-203-1080
Practice Address - Fax:509-203-1077
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9421GAOtherREGENCE
15835OtherGROUP HEALTH
WA0186445OtherL & I
WA9638933Medicaid
911019392OtherCOMMERCIAL
15835OtherGROUP HEALTH
WA9421GAOtherREGENCE