Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH00006215 | WA |
NPI | 1053446591 |
---|---|
Provider Name | Jeannie M Appelhof |
First Address | Yakima, WA 98907-2605 |
Second Address | Yakima, WA 98901-3020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5043518 | (05) | WA |