Provider Demographics
NPI:1184246688
Name:BAHENA, MIREYA ANN
Entity type:Individual
Prefix:
First Name:MIREYA
Middle Name:ANN
Last Name:BAHENA
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 1:212 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-9790
Mailing Address - Country:US
Mailing Address - Phone:509-881-9724
Mailing Address - Fax:
Practice Address - Street 1:CATHOLIC CHARITIES OF THE DIOCESE OF 145 S. WORTHEN ST.
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-662-6761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator