Healthcare Provider Details

I. General information

NPI: 1578649638
Provider Name (Legal Business Name): YAKIMA VALLEY FARM WORKERS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 W 1ST AVE
TOPPENISH WA
98948-1564
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-3886
  • Fax: 509-865-6391
Mailing address:
  • Phone: 509-865-3886
  • Fax: 509-865-6391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE TROTTER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 509-865-6175