Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idalis Amadaley Licea

Individual provider Ambulatory Care Registered Nurse · NPI 1407789001

Idalis Amadaley Licea is an Ambulatory Care Registered Nurse in Prosser, Washington. Licensed in Washington. Registered with an NPI since 2026.

Licensed in
WA
In the registry since
2026

Practice location Address checks out

326 Chardonnay Ave
Prosser, WA 99350-9515
Phone: (509) 786-1576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Care Registered Nurse (primary) Taxonomy 163WP2201X · Licence 61382393 (WA)

Record details

NPI number1407789001
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 4, 2026
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026
Mailing address1611 Diamond Ave, Grandview, WA 98930-6118