Basic Information
| Provider Information | |||||||||
| NPI: | 1790119428 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH MED PROFESSIONAL GROUP, P.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2557 TURNING LEAF LANE | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606327366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 205 STEWART RD, SUITE 104 | ||||||||
| Address2: | |||||||||
| City: | MT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604163322 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2013 | ||||||||
| LastUpdateDate: | 08/29/2013 | ||||||||
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| AuthorizedOfficialLastName: | ESPARZA | ||||||||
| AuthorizedOfficialFirstName: | YVETTE | ||||||||
| AuthorizedOfficialMiddleName: | ANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER, PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3606327366 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | ARNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP30006622 | WA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.