Provider Demographics
NPI:1013592013
Name:GONZALEZ, EMILY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98903-2427
Mailing Address - Country:US
Mailing Address - Phone:541-704-5922
Mailing Address - Fax:
Practice Address - Street 1:2113 68TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-2427
Practice Address - Country:US
Practice Address - Phone:541-704-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60549966163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant