Basic Information
| Provider Information | |||||||||
| NPI: | 1285371443 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOMINGUEZ NAJERA | ||||||||
| FirstName: | DULCE | ||||||||
| MiddleName: | KIRBETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2605 | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989072605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094544143 | ||||||||
| FaxNumber: | 5094544115 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 S 8TH ST | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989013020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094544143 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2022 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | RN61222228 | WA | N | Other Service Providers | Case Manager/Care Coordinator | 163W00000X | RN61222228 | WA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.