MEDICARE: YAKIMA COUNTY DEPARTMENT OF CORRECTIONS

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	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1992663355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YAKIMA COUNTY DEPARTMENT OF CORRECTIONS

Provider Business Mailing Address
First Line	:	111 N FRONT ST
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-2638
Country	:	US
Telephone Number	:	509-574-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 N FRONT ST
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-2638
Country	:	US
Telephone Number	:	509-574-1654
Fax Number	:

Authorized Official
Title or Position	:	LIEUTENANT
Name	:	TRAVIS IRION
Credential	:
Telephone Number	:	509-574-1625

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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