Healthcare Provider Details

I. General information

NPI: 1144304692
Provider Name (Legal Business Name): LISA BENOIT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 N 16TH AVE
YAKIMA WA
98902-1381
US

IV. Provider business mailing address

PO BOX 9787
YAKIMA WA
98909-0787
US

V. Phone/Fax

Practice location:
  • Phone: 509-574-3300
  • Fax:
Mailing address:
  • Phone: 509-574-3350
  • Fax: 509-225-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30006721
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: