Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60149404 | WA |
NPI | 1023221363 |
---|---|
Provider Name | Mrs. Jodi Christine Buffington |
First Address | Yakima, WA 98909-0787 |
Second Address | Yakima, WA 98902-3761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0268183 | L&I (01) | WA |
2008346 | (05) | WA |