Individual provider · Type 1 NPI

Etinosa Lopez Ebagua, PA-C

Medical Physician Assistant · Othello, WA

NPI number 1700655701 Active

Practice location

1515 E Columbia St
Othello, WA 99344-1846

Fax (509) 488-9939

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA70190314 (WA)

Medical Physician Assistant: Definition to come...

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About NPI 1700655701

Etinosa Lopez Ebagua, PA-C's National Provider Identifier is 1700655701, issued on Jan 1, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Othello, WA. The record was last updated on Oct 16, 2026.