Basic Information
| Provider Information | |||||||||
| NPI: | 1265744577 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE MARCO GARCIA | ||||||||
| FirstName: | LORENA | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 SUMMITVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989022715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092487849 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1607 CREEKSIDE LOOP | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989024882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094534614 | ||||||||
| FaxNumber: | 5092252712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2010 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | MD60158449 | WA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.