Azalia Acosta

Individual provider Active NPI Case Manager/Care Coordinator · Othello, WA

NPI 1326508672 · NPPES record last updated Mar 22, 2019

Key facts

NPI
1326508672
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
CG60941622 (WA)
Practice address
425 E Main St Ste 600
Othello, WA 99344-1146
Phone
(509) 488-4074
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CG60941622WAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
County of Adams Case Manager/Care Coordinator Past Accepting new patients
County of Adams Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CG60941622 WA Yes

Addresses

Primary practice location

425 E Main St Ste 600
Othello, WA 99344-1146

Mailing address

425 E Main St Ste 600
Othello, WA 99344-1146
Phone (509) 488-4074

Other identifiers

IdentifierTypeStateIssuer
CG60941622OtherWAAGENCY AFFILIATION REGISTRATION

Other providers in Othello, WA

All providers in Othello, WA · Case Manager/Care Coordinator in Washington

Sources for this page

Verify at the official NPI Registry.