Provider Demographics
NPI:1790871986
Name:IOVINO, YVANA (MD)
Entity Type:Individual
Prefix:
First Name:YVANA
Middle Name:
Last Name:IOVINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-0190
Mailing Address - Country:US
Mailing Address - Phone:509-865-5898
Mailing Address - Fax:
Practice Address - Street 1:518 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1564
Practice Address - Country:US
Practice Address - Phone:509-865-5600
Practice Address - Fax:509-865-5783
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029556207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3419OtherGROUP HEALTH
WA8138729OtherCHPW
WA8138729Medicaid
911019392OtherCOMMERCIAL
WA78542OtherL & I
WAIO1002OtherREGENCE
AB16837Medicare ID - Type UnspecifiedRR MEDICARE
GAB16837Medicare ID - Type Unspecified
WA8138729OtherCHPW