Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP61188295 | WA |
NPI | 1023688769 |
---|---|
Provider Name | James Kendall Eakin |
First Address | Yakima, WA 98907-2605 |
Second Address | Yakima, WA 98901-3020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2021 |
Last Update Date | 15/07/2021 |