Provider Demographics
NPI:1760096689
Name:LEPE, ANASTACIO
Entity Type:Individual
Prefix:
First Name:ANASTACIO
Middle Name:
Last Name:LEPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 RICHEY RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2300
Mailing Address - Country:US
Mailing Address - Phone:509-388-3508
Mailing Address - Fax:509-283-1018
Practice Address - Street 1:2902 RICHEY RD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2300
Practice Address - Country:US
Practice Address - Phone:509-388-3508
Practice Address - Fax:509-283-1018
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA11159171R00000X
WA18182171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter