Healthcare Provider Details

I. General information

NPI: 1720918436
Provider Name (Legal Business Name): YAKIMA NEUROPSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4804 SUMMITVIEW AVE STE 2
YAKIMA WA
98908-2850
US

IV. Provider business mailing address

4804 SUMMITVIEW AVE STE 2
YAKIMA WA
98908-2850
US

V. Phone/Fax

Practice location:
  • Phone: 877-899-3247
  • Fax: 509-268-2993
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH FAIR
Title or Position: DR.
Credential:
Phone: 877-899-3247