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NPI Code Detail

MEDICARE: ROBERTA SUE YOSHIMURA PA

MEDICARE: ROBERTA SUE YOSHIMURA PA
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
1363AM0700XMedical Physician AssistantPA10005017WA

General Provider Information

NPI Number : 1306820881
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTA SUE YOSHIMURA PA
Provider Business Mailing Address
First Line : 4751 354TH AVE SE
Second Line :
City : FALL CITY
State : WA
Zip : 98024-9704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 134 188TH ST S
Second Line :
City : SPANAWAY
State : WA
Zip : 98387-4618
Country : US
Telephone Number : 253-847-2304
Fax Number : 253-847-2304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 03/07/2023

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Directions to “ ROBERTA SUE YOSHIMURA PA” Practice Location

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