Basic Information
Provider Information
NPI: 1821686395
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AUSTIN
FirstName: JOYCE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 201 S 2ND AVE
Address2:  
City: YAKIMA
State: WA
PostalCode: 989023464
CountryCode: US
TelephoneNumber: 2515764316
FaxNumber: 5092256308
Practice Location
Address1: 402 S 4TH AVE
Address2:  
City: YAKIMA
State: WA
PostalCode: 989023546
CountryCode: US
TelephoneNumber: 5095754084
FaxNumber: 5092256313
Other Information
ProviderEnumerationDate: 01/09/2021
LastUpdateDate: 02/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0809X61131273WAN Nursing Service ProvidersRegistered NursePsych/Mental Health, Adult
363LP0808XAP61131273WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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