Yakima Valley Medical Conference Registration 26: Submission #1605

Submission Number: 1605
Submission ID: 4638
Submission UUID: 4529b767-9489-406b-a1bf-78b8c6ef9801
Submission URI: /yakima26/form

Created: Tue, 01/20/2026 - 02:45
Completed: Tue, 01/20/2026 - 02:45
Changed: Tue, 01/20/2026 - 02:45

Remote IP address: 192.88.134.7
Submitted by: Anonymous
Language: English

Is draft: No
Current page: Complete
First Name: Nichole
Last Name: Bosma
Email: nibosma@hotmail.com
Degree: N.P.
Specialty: Family Medicine 
Clinic/Organization: Family Medicine of Yakima
Conference Format: {Empty}
Address: 123 Lyle Loop Rd
City: Selah, WA PST
State: WA
Zip: 98942
Phone: 9712350578
Payment:  Card payment
Conference type: Complete Conference
Thursday: {Empty}
Friday: In Person
Saturday: In Person
Notes: {Empty}
anet_transaction_reference: ref1768877156
anet_payment_status: success
Ammount: 422.37
Registration code: yakima26
Title: Yakima Valley Medical Conference 26
Receipt: http://russocme.com/webform/paid_conference_registration/submissions/4638/attachment/receipt/receipt.pdf
Payment Note: RussoCME
935 SE High St
Pullman, WA 99163
Invoice number: yakima26_1768877148
Tax: 32.37
Base amount: 390
Taxed Amount: 390
Total Days: 2
Recording Days: 0
Non Recording Days: 2
Per Day Amount: 195
Tax Percentage: 8.3