Healthcare Provider Details

I. General information

NPI: 1225817182
Provider Name (Legal Business Name): CASCADE PSYCHOLOGICAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S 40TH AVE STE 18
YAKIMA WA
98908-3867
US

IV. Provider business mailing address

520 HENNESSY RD
YAKIMA WA
98908-9533
US

V. Phone/Fax

Practice location:
  • Phone: 509-367-6130
  • Fax:
Mailing address:
  • Phone: 724-541-2701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. DEREK HATFIELD
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 724-541-2701