Basic Information
| Provider Information | |||||||||
| NPI: | 1942846993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEJIA CAMACHO | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Credential: | CMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1422 S 8TH ST | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989013548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094806554 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 918 E MEAD AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989033720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094531344 | ||||||||
| FaxNumber: | 5094532209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2019 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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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 | 376K00000X | WA | Y | Nursing Service Related Providers | Nurse's Aide |
No ID Information.