Healthcare Provider Details

I. General information

NPI: 1144876905
Provider Name (Legal Business Name): YAKIMA VALLEY FARM WORKERS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 W DESCHUTES PL
KENNEWICK WA
99336-7719
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-6175
  • Fax:
Mailing address:
  • Phone: 509-865-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE TROTTER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 508-865-6175