Healthcare Provider Details

I. General information

NPI: 1073435707
Provider Name (Legal Business Name): AUDRIANA KRISTINE ALFARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PHYSICAL EDUCATION CLASSROOM BUILDING EASTERN WA UN
CHENEY WA
99004
US

IV. Provider business mailing address

200 PHYSICAL EDUCATION CLASSROOM BUILDING EASTERN WA UN
CHENEY WA
99004
US

V. Phone/Fax

Practice location:
  • Phone: 509-359-2427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: