MEDICARE: MINDY TANIMOTO ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP60692107	WA

General Provider Information

NPI Number	:	1043767122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY TANIMOTO ARNP

Provider Business Mailing Address
First Line	:	560 GAGE BLVD
Second Line	:	SUITE 203
City	:	RICHLAND
State	:	WA
Zip	:	99352
Country	:	US
Telephone Number	:	509-942-3627
Fax Number	:	509-942-2268

Provider Business Practice Location Address
First Line	:	124 W KENNEWICK AVE STE 11
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-3830
Country	:	US
Telephone Number	:	541-303-3558
Fax Number	:	509-593-4644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2016
Last Update Date	:	06/10/2026

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Directions to “ MINDY TANIMOTO ARNP” Practice Location

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