Provider Demographics
NPI:1023221363
Name:BUFFINGTON, JODI CHRISTINE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:CHRISTINE
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:CHRISTINE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 9787
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98909-0787
Mailing Address - Country:US
Mailing Address - Phone:509-575-8255
Mailing Address - Fax:509-225-3168
Practice Address - Street 1:2811 TIETON DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3761
Practice Address - Country:US
Practice Address - Phone:509-575-8307
Practice Address - Fax:509-577-5093
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00142299163W00000X
WAAP60149404363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0268183OtherL&I
WA2008346Medicaid
WA0268183OtherL&I