Basic Information
| Provider Information | |||||||||
| NPI: | 1356380356 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPARZA | ||||||||
| FirstName: | YVETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 NE GOLDIE ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982772727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606327366 | ||||||||
| FaxNumber: | 3607202812 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982734210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604505000 | ||||||||
| FaxNumber: | 3604505051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | AP30006622 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 363LP0808X | AP30006622 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | AP30006622 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 9641846 | 05 | WA | MEDICAID |