Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD2011-0120 | NM |
Y | 207Q00000X | Family Doctor | MD61105286 | WA |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD61105286 | WA |
NPI | 1053514497 |
---|---|
Provider Name | Dr. Nicole Joy Yonke |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Vancouver, WA 98663-2776 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 27/01/2021 |