Provider Demographics
NPI:1598942062
Name:VON AU, DARLENE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:VON AU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 SUMMITVIEW AVE
Mailing Address - Street 2:SUITE 5-234
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2953
Mailing Address - Country:US
Mailing Address - Phone:509-952-1296
Mailing Address - Fax:
Practice Address - Street 1:4001 SUMMITVIEW AVE
Practice Address - Street 2:SUITE 5-234
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2953
Practice Address - Country:US
Practice Address - Phone:509-952-1296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00000952174400000X
ORA36350174400000X
CAOTA1578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist