1952866170 NPI number — MRS. REYNE LEE-ARBUCKLE YAMANE FNP

Table of content: MRS. REYNE LEE-ARBUCKLE YAMANE FNP (NPI 1952866170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952866170 NPI number — MRS. REYNE LEE-ARBUCKLE YAMANE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YAMANE
Provider First Name:
REYNE
Provider Middle Name:
LEE-ARBUCKLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952866170
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2901 BRIDGEPORT WAY W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY PLACE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98466-4614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-534-7000
Provider Business Mailing Address Fax Number:
253-534-7099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 1244
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98346-1244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-714-3944
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP61041232 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2155640 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com