MEDICARE: SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician
3	207RN0300X	Nephrology Physician
4	207X00000X	Orthopaedic Surgery Physician
5	213E00000X	Podiatrist
6	261QU0200X	Urgent Care Clinic/Center
7	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1841639119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 719
Second Line	:
City	:	SUNNYSIDE
State	:	WA
Zip	:	98944-0719
Country	:	US
Telephone Number	:	509-836-4848
Fax Number	:	509-837-4908

Provider Business Practice Location Address
First Line	:	2705 E LINCOLN AVE
Second Line	:
City	:	SUNNYSIDE
State	:	WA
Zip	:	98944-4006
Country	:	US
Telephone Number	:	509-836-4848
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	KIM LAWSON
Credential	:
Telephone Number	:	509-837-1617

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	02/04/2019

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Directions to “SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION ” Practice Location

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