Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP 30001738 | WA |
NPI | 1013993666 |
---|---|
Provider Name | Delila C Ojeda |
First Address | Walla Walla, WA 99362-4118 |
Second Address | Walla Walla, WA 99362-4118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 02/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R94365 | (02) |