Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60480682 | WA |
NPI | 1003213463 |
---|---|
Provider Name | Karen Yepez |
First Address | Portland, OR 97208-3360 |
Second Address | Olympia, WA 98506-5197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2014 |
Last Update Date | 11/08/2017 |