Healthcare Provider Details

I. General information

NPI: 1386109403
Provider Name (Legal Business Name): ARACELY POLANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 EAST MEAD AVE
YAKIMA WA
98903
US

IV. Provider business mailing address

PO BOX 190
YAKIMA WA
98907-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-453-1344
  • Fax:
Mailing address:
  • Phone: 509-865-2395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWI.LW.61539738
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: