Provider Demographics
NPI:1376279141
Name:LAKEY, YVONNE CHRISTINE
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:CHRISTINE
Last Name:LAKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:CHRISTINE
Other - Last Name:FRANZ-LAKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CG61308986
Mailing Address - Street 1:PO BOX 997
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0997
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 N 2ND ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2334
Practice Address - Country:US
Practice Address - Phone:509-643-8425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61308986175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACG61308986OtherPEER SUPPORT