Healthcare Provider Details

I. General information

NPI: 1023221363
Provider Name (Legal Business Name): JODI CHRISTINE BUFFINGTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JODI CHRISTINE HUGHES ARNP

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 TIETON DR
YAKIMA WA
98902-3761
US

IV. Provider business mailing address

PO BOX 9787
YAKIMA WA
98909-0787
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-8307
  • Fax: 509-577-5093
Mailing address:
  • Phone: 509-575-8255
  • Fax: 509-225-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60149404
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00142299
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: