Healthcare Provider Details

I. General information

NPI: 1275670580
Provider Name (Legal Business Name): YAKAMA INDIAN HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BUSTER RD
TOPPENISH WA
98948-9792
US

IV. Provider business mailing address

401 BUSTER RD
TOPPENISH WA
98948-9792
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-2102
  • Fax: 509-865-5064
Mailing address:
  • Phone: 509-865-2102
  • Fax: 509-865-5064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA HARRIS
Title or Position: MEDICAL SUPPORT ASSISTANT
Credential:
Phone: 509-865-2102