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NPI Code Detail

MEDICARE: YAKIMA VALLEY FARM WORKERS CLINIC

MEDICARE: YAKIMA VALLEY FARM WORKERS CLINIC
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
13336C0003XCommunity/Retail PharmacyCF00057072WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24929571OTHERWANCPDP

General Provider Information

NPI Number : 1831285162
Entity Type Code : Organization
Provider Name (Legal Business Name) : YAKIMA VALLEY FARM WORKERS CLINIC
Provider Business Mailing Address
First Line : 2601 COMMERCE LN
Second Line :
City : YAKIMA
State : WA
Zip : 98901-5801
Country : US
Telephone Number : 509-865-6175
Fax Number : 509-865-0840
Provider Business Practice Location Address
First Line : 120 W MISSION AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-2322
Country : US
Telephone Number : 509-323-8757
Fax Number : 509-326-0739
Authorized Official
Title or Position : COO
Name : GLEN DAVIS
Credential :
Telephone Number : 509-865-6175
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/01/2024

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Directions to “YAKIMA VALLEY FARM WORKERS CLINIC ” Practice Location

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