Kallis, Dianna M

Kallis, Dianna M is an individual health care provider with primary practice located at 611 N 39Th Ave , Yakima WA 98902-6348. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kallis, Dianna M can be contacted via phone (509) 249-1288.

Contact Information

Primary practice address
611 N 39Th Ave Yakima WA 98902-6348
Phone: (509) 249-1288
Fax: (509) 249-6249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN00048090 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30004094 Washington

Profile Details

NPI number 1679583702
LBN Legal business name Kallis, Dianna M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Feb 11th, 2014 - about 10 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 1679583702 NPPES
Washington MEDICAID 9643420

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