Acosta, Azalia
Acosta, Azalia is an individual health care provider with primary practice located at 425 E Main St Ste 600 , Othello WA 99344-1146. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Acosta, Azalia can be contacted via phone (509) 488-4074.Contact Information
Primary practice address
425 E Main St Ste 600
Othello WA 99344-1146
Phone: (509) 488-4074
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | CG60941622 | Washington |
Profile Details
| NPI number | 1326508672 |
|---|---|
| LBN Legal business name | Acosta, Azalia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2019 |
| Last updated | Mar 22nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326508672 | NPPES |
| Washington | Other | CG60941622 | AGENCY AFFILIATION REGISTRATION |
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