Individual provider · NPI-1
Deanne L Ristau, RMA
Technician · Omak, WA
NPI number1821620204
StatusActive
Last updated in NPPESFeb 4, 2020
Details
- NPI
- 1821620204
- Entity type
- Individual (NPI-1)
- Name
- Deanne L Ristau
- Credential
- RMA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 4, 2020
- Certification date
- Feb 4, 2020
- Last updated
- Feb 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374700000X | Technician | 175315 | – | Yes |
Practice location
617 Benton StOmak, WA 98841-9636
Phone 509-422-7541 · Fax 509-422-7471
Mailing address
617 Benton StOmak, WA 98841-9636
Phone 509-422-7541 · Fax 509-422-7471
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