MEDICARE: NAOMI FORREST

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1063991925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI FORREST

Provider Business Mailing Address
First Line	:	PO BOX 959
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98907-0959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 W 10TH AVE
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-6300
Country	:	US
Telephone Number	:	509-575-4084
Fax Number	:

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

Provider Enumeration Date	:	08/11/2018
Last Update Date	:	04/13/2026

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Directions to “ NAOMI FORREST ” Practice Location

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