Provider Demographics
NPI:1699214635
Name:ANDINO, JULIE (RN60292293)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ANDINO
Suffix:
Gender:F
Credentials:RN60292293
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1549
Mailing Address - Country:US
Mailing Address - Phone:509-853-6805
Mailing Address - Fax:509-823-4220
Practice Address - Street 1:420 S 32ND AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3635
Practice Address - Country:US
Practice Address - Phone:509-823-4200
Practice Address - Fax:509-823-4220
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60292293163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse