Provider Demographics
NPI:1205618717
Name:CERVANTES, YVETT GARCIA (LMT)
Entity type:Individual
Prefix:
First Name:YVETT
Middle Name:GARCIA
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3002
Mailing Address - Country:US
Mailing Address - Phone:509-579-0270
Mailing Address - Fax:
Practice Address - Street 1:2601 W FALLS AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3002
Practice Address - Country:US
Practice Address - Phone:509-579-0270
Practice Address - Fax:509-579-0269
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61492259225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist