Provider Demographics
NPI:1356380356
Name:ESPARZA, YVETTE (ARNP)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4210
Mailing Address - Country:US
Mailing Address - Phone:360-450-5000
Mailing Address - Fax:360-450-5051
Practice Address - Street 1:825 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4210
Practice Address - Country:US
Practice Address - Phone:360-450-5000
Practice Address - Fax:360-450-5051
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAP30006622207P00000X
WAAP30006622363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9641846Medicaid
WA9641846Medicaid