Healthcare Provider Details

I. General information

NPI: 1063131274
Provider Name (Legal Business Name): MISS TESS ASTLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 VALLEY MALL PKWY STE A
WENATCHEE WA
98802-4838
US

IV. Provider business mailing address

616 VALLEY MALL PKWY STE A
WENATCHEE WA
98802-4838
US

V. Phone/Fax

Practice location:
  • Phone: 509-888-3496
  • Fax:
Mailing address:
  • Phone: 509-888-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61324303
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: