Most Relevant Information
Provider Data
| NPI Number: | 1003250663 |
| Provider Name: | JENATTE VIRGINIA CLARK ARNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP 60329890 |
Most Important Dates
| Enumeration Date: | 04/24/2013 |
| Last Updated: | 11/10/2021 |
Provider Practice Location
4209 TIETON DR STE 102
YAKIMA
WA
989083377
Practice Location Phone/Fax
| Phone: | 5096549810 |
| Fax: | 5099668812 |
Provider Mailing Location
4209 TIETON DR STE 102
YAKIMA
WA
989083377
Provider Mailing Phone/Fax
| Phone: | 5096549810 |
| Fax: | 5099668812 |