Basic Information
| Provider Information | |||||||||
| NPI: | 1720641533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMERO | ||||||||
| FirstName: | LYSBETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 EASTMONT AVE | ||||||||
| Address2: | |||||||||
| City: | EAST WENATCHEE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988024039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094700322 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1014 WALLA WALLA AVE | ||||||||
| Address2: | |||||||||
| City: | WENATCHEE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988011523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096630034 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2019 | ||||||||
| LastUpdateDate: | 04/17/2019 | ||||||||
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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 | 175T00000X | Y |
No ID Information.