Black, Vicki L

Black, Vicki L is an individual health care provider with primary practice located at 1806 W Lincoln Ave , Yakima WA 98902-2473. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Black, Vicki L can be contacted via phone (509) 452-4520.

Contact Information

Primary practice address
1806 W Lincoln Ave Yakima WA 98902-2473
Phone: (509) 452-4520
Fax: (509) 452-5224
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00015749 Washington

Profile Details

NPI number 1609875038
LBN Legal business name Black, Vicki L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated May 16th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609875038 NPPES
Washington Other 0039695 LABOR & INDUSTRIES
Washington MEDICAID 1034487 LABOR & INDUSTRIES
Washington Other P000050810 LABOR & INDUSTRIES
Washington Other 8931362 LABOR & INDUSTRIES

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