Provider Demographics
NPI:1942844287
Name:ANDERSON, ESMERALDA CHAVEZ (APRN)
Entity Type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:CHAVEZ
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 SUMMITVIEW AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3027
Mailing Address - Country:US
Mailing Address - Phone:509-454-6300
Mailing Address - Fax:509-454-6301
Practice Address - Street 1:6201 SUMMITVIEW AVE STE 106
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3027
Practice Address - Country:US
Practice Address - Phone:509-454-6300
Practice Address - Fax:509-454-6301
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61014320363LP0808X, 163WP0808X
WA61016533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine