Healthcare Provider Details

I. General information

NPI: 1356340624
Provider Name (Legal Business Name): CITY OF SUNNYSIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 S 8TH ST
SUNNYSIDE WA
98944
US

IV. Provider business mailing address

513 S 8TH ST
SUNNYSIDE WA
98944-2275
US

V. Phone/Fax

Practice location:
  • Phone: 509-837-3999
  • Fax: 509-836-6419
Mailing address:
  • Phone: 509-837-3999
  • Fax: 509-836-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number39M06
License Number StateWA

VIII. Authorized Official

Name: MRS. JAMISON K HORNER
Title or Position: FINANCE AND ADMIN SERVICES DIRECTOR
Credential: CPC/CMA/HCA
Phone: 509-836-6392