Healthcare Provider Details

I. General information

NPI: 1053418525
Provider Name (Legal Business Name): JOANN ALLISON R.N.F.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SOUTH 9TH AVE
YAKIMA WA
98901
US

IV. Provider business mailing address

P.O. BOX 2366
YAKIMA WA
98907-2366
US

V. Phone/Fax

Practice location:
  • Phone: 509-969-1951
  • Fax: 509-577-0147
Mailing address:
  • Phone: 509-969-1951
  • Fax: 509-577-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN00069935
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. JO ANN ALLISON
Title or Position: R.N.F.A.
Credential: R.N.FIRST ASSISANT
Phone: 509-969-1951