| Idalis Amadaley Licea, | |
|
326 Chardonnay Ave, Prosser, WA 99350-9515 | |
| (509) 786-1576 | |
| Not Available |
| Full Name | Idalis Amadaley Licea |
|---|---|
| Gender | Female |
| Speciality | Registered Nurse - Ambulatory Care |
| Location | 326 Chardonnay Ave, Prosser, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407789001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WP2201X | Registered Nurse - Ambulatory Care | 61382393 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Idalis Amadaley Licea, 1611 Diamond Ave, Grandview, WA 98930-6118 Ph: (509) 786-1576 | Idalis Amadaley Licea, 326 Chardonnay Ave, Prosser, WA 99350-9515 Ph: (509) 786-1576 |
Mrs. Amy Shook, CRNFA Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 723 Memorial St, Prosser, WA 99350 Phone: 509-786-6676 | |
Alison Bestebreur, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 832 Park Ave, Prosser, WA 99350 Phone: 509-786-2020 | |
Savannah Capener, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1023 Anna St, Prosser, WA 99350 Phone: 509-778-2149 | |
Ashley Marie Olson, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 200 Prosser Health Dr, Prosser, WA 99350 Phone: 509-786-2222 | |
Danielle Crawford, CPNP-PC, ARNP Registered Nurse Medicare: May Accept Medicare Assignments Practice Location: 336 Chardonnay Ave Ste A, Prosser, WA 99350 Phone: 509-750-4058 | |
William Harrison Smith, CRNA Registered Nurse Medicare: Medicare Enrolled Practice Location: 1215 Quarterhorse Trl, Prosser, WA 99350 Phone: 509-786-2888 Fax: 509-786-2888 |