Healthcare Provider Details

I. General information

NPI: 1013843382
Provider Name (Legal Business Name): KACIE B BISCONER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 TIETON DR STE 230
YAKIMA WA
98902-3684
US

IV. Provider business mailing address

719 N 74TH AVE
YAKIMA WA
98908-1256
US

V. Phone/Fax

Practice location:
  • Phone: 509-746-4189
  • Fax: 509-249-4460
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number60674804
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: