Healthcare Provider Details
I. General information
NPI: 1790604635
Provider Name (Legal Business Name): BAYAN HEALTH WA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 W YAKIMA AVE STE 4B
YAKIMA WA
98902-3096
US
IV. Provider business mailing address
901 W YAKIMA AVE STE 4B
YAKIMA WA
98902-3096
US
V. Phone/Fax
- Phone: 925-989-7548
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CASSIDY
BRINK
Title or Position: CREDENTIALER
Credential:
Phone: 989-240-6712