Healthcare Provider Details

I. General information

NPI: 1669958500
Provider Name (Legal Business Name): PINNACLE SLEEP AND WAKE DISORDERS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2018
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 CHARDONNAY AVE
PROSSER WA
99350-9515
US

IV. Provider business mailing address

PO BOX 8051
YAKIMA WA
98908-0051
US

V. Phone/Fax

Practice location:
  • Phone: 509-737-1447
  • Fax:
Mailing address:
  • Phone: 509-469-1903
  • Fax: 509-469-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHETA NAND
Title or Position: OWNER
Credential: MD
Phone: 509-737-1447