Provider Demographics
NPI:1255616678
Name:YBARRA, ARLENE (PA-C)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:YBARRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 REID ST # A
Mailing Address - Street 2:ATTN: MCHJ-CLQ-C
Mailing Address - City:JOINT BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:210-865-1157
Mailing Address - Fax:253-968-3278
Practice Address - Street 1:9040 REID ST # A
Practice Address - Street 2:ATTN: MCHJ-CLQ-C
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:210-865-1157
Practice Address - Fax:253-968-3278
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical