Provider Demographics
NPI:1760675631
Name:CONTRERAS, ANNIE
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:
Last Name:CONTRERAS
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 1:602 E NOB HILL BLVD
Mailing Address - Street 2:CHS
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-3534
Mailing Address - Country:US
Mailing Address - Phone:509-457-6540
Mailing Address - Fax:509-453-6144
Practice Address - Street 1:602 E NOB HILL BLVD
Practice Address - Street 2:CHS
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-3534
Practice Address - Country:US
Practice Address - Phone:509-457-6540
Practice Address - Fax:509-453-6144
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator