Healthcare Provider Details

I. General information

NPI: 1861377228
Provider Name (Legal Business Name): ALISON YOMIRA MARIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E D ST STE 5
YAKIMA WA
98901-2300
US

IV. Provider business mailing address

303 E D ST STE 5
YAKIMA WA
98901-2300
US

V. Phone/Fax

Practice location:
  • Phone: 509-453-1300
  • Fax: 509-453-2362
Mailing address:
  • Phone: 509-453-1300
  • Fax: 509-453-2362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70166551
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSC70166551
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: