Healthcare Provider Details

I. General information

NPI: 1114259751
Provider Name (Legal Business Name): SONJA H HUEBNER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 E MANITOBA AVE
ELLENSBURG WA
98926
US

IV. Provider business mailing address

716 E MANITOBA AVE
ELLENSBURG WA
98926-3842
US

V. Phone/Fax

Practice location:
  • Phone: 509-925-3151
  • Fax: 509-925-4382
Mailing address:
  • Phone: 509-925-3151
  • Fax: 509-925-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60101191
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: