Healthcare Provider Details

I. General information

NPI: 1548307929
Provider Name (Legal Business Name): YAKAMA INDIAN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 03/07/2023
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: 509-865-4986
Mailing address:
  • Phone: 509-865-2102
  • Fax: 509-865-4986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JAY SAMPSON
Title or Position: CEO
Credential:
Phone: 509-865-2102