Washoe Tribe of Nevada and California

NPI #1043608243 in Gardnerville, Nevada

Provider Information

NPI Number: 1043608243
Entity Type: Organization
Organization Name: Washoe Tribe of Nevada and California
Primary Specialty: General Practice
Enumeration Date: Dec 23, 2014
Last Updated: Dec 23, 2014

Practice Location

Address: 1559 WATASHEAMU
City: Gardnerville
State: Nevada
ZIP Code: 89460-7455
Phone: (775) 265-4215

Authorized Official

Name: MRS. ROSEANN KIZER
Title: CREDENTIALING COORDINATOR
Phone: (775) 265-4215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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