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Tracy Leeann Keniston, PA-C
Surgical Physician Assistant in Yakima, Washington
NPI 1457549545

Tracy Leeann Keniston is a Surgical Physician Assistant based in Yakima, WA and is specialized in Surgical. Tracy Leeann Keniston practices in Yakima, WA and has the professional credentials of PA-C. The NPI Number for Tracy Leeann Keniston is 1457549545 and holds a License No. PA10005307 (Washington).

The current practice location address for Tracy Leeann Keniston is 111 S 11Th Ave Ste 320, Yakima, WA and can be reached out via phone at 509-454-8888 and via fax at 509-453-0061. You can also correspond with Tracy Leeann Keniston through the mailing address at PO BOX 2309, YAKIMA, WA - 98907-2309 (mailing address contact number: 509-454-8888).

Location: 111 S 11Th Ave Ste 320, Yakima, WA, 98907-2309
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Provider Profile Details
NPI Number
1457549545
Provider Name
Tracy Leeann Keniston
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
111 S 11Th Ave Ste 320, Yakima, WA, 98907-2309
Phone Number
509-454-8888
Fax Number
509-453-0061
Provider Enumeration Date
10/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA10005307 01 WA WA PA LICENSE
1057024 05 WA
institution
Provider Business Practice Location Address Details
Address
111 S 11Th Ave Ste 320
City
State
Zip
98902-3273
Phone Number
509-454-8888
Fax Number
509-453-0061
person
Provider Business Mailing Address Details
Address
111 S 11Th Ave Ste 320
City
State
Zip
98902-3273
Phone Number
509-454-8888
Fax Number
509-453-0061
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA10005307 (Washington)
Definition
Definition to come...
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