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NPI Code Detail

MEDICARE: DSHS/DDA/YAKIMA VALLEY SCHOOL

MEDICARE: DSHS/DDA/YAKIMA VALLEY SCHOOL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility342007865WA
2313M00000XNursing Facility/Intermediate Care Facility

General Provider Information

NPI Number : 1639129695
Entity Type Code : Organization
Provider Name (Legal Business Name) : DSHS/DDA/YAKIMA VALLEY SCHOOL
Provider Business Mailing Address
First Line : 609 SPEYERS ROAD
Second Line :
City : SELAH
State : WA
Zip : 98942-1050
Country : US
Telephone Number : 509-698-1300
Fax Number : 509-697-2230
Provider Business Practice Location Address
First Line : 609 SPEYERS ROAD
Second Line :
City : SELAH
State : WA
Zip : 98942-1050
Country : US
Telephone Number : 509-698-1300
Fax Number : 509-698-2230
Authorized Official
Title or Position : SUPERINTENDENT
Name : MRS. TAMMY K. WINEGAR
Credential : NURSING HOME ADMINIS
Telephone Number : 509-698-1255
Provider Enumeration Date : 05/11/2006
Last Update Date : 11/01/2016

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Directions to “DSHS/DDA/YAKIMA VALLEY SCHOOL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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