Provider Demographics
NPI:1477903029
Name:DEL VALLE, OSCAR (MSN -FNP)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:DEL VALLE
Suffix:
Gender:M
Credentials:MSN -FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DALE AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON CITY
Mailing Address - State:WA
Mailing Address - Zip Code:99320-5250
Mailing Address - Country:US
Mailing Address - Phone:509-588-4075
Mailing Address - Fax:
Practice Address - Street 1:701 DALE AVE
Practice Address - Street 2:
Practice Address - City:BENTON CITY
Practice Address - State:WA
Practice Address - Zip Code:99320-5250
Practice Address - Country:US
Practice Address - Phone:509-588-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003751363L00000X
WAAP 60643416363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner