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1942290275

NPI Code Detail

MEDICARE: DR. JOHN M ASRIEL SR. MD

MEDICARE: DR. JOHN M ASRIEL SR. MD

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
1	207Q00000X	Family Medicine Physician	22349	KY
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	MD00020220	WA
3	208M00000X	Hospitalist Physician	MD00020220	WA
4	207Q00000X	Family Medicine Physician	MD00020220	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00889471	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0263423	OTHER	WA	LABOR & INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942290275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M ASRIEL SR. MD

Provider Business Mailing Address
First Line	:	501 S 5TH AVE
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98902-3550
Country	:	US
Telephone Number	:	509-494-6700
Fax Number	:	509-573-6275

Provider Business Practice Location Address
First Line	:	521 E MOUNTAIN VIEW AVE
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-3865
Country	:	US
Telephone Number	:	509-962-1414
Fax Number	:	509-962-1408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/22/2019

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Directions to “ DR. JOHN M ASRIEL SR. MD” Practice Location

Language	Start Address	Practice Location

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