Healthcare Provider Details

I. General information

NPI: 1295649705
Provider Name (Legal Business Name): DIGNITY FIRST PROJECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S 12TH AVE
YAKIMA WA
98902-3113
US

IV. Provider business mailing address

201 JIM CLEMENTS WAY APT 9
SELAH WA
98942-4349
US

V. Phone/Fax

Practice location:
  • Phone: 509-262-6232
  • Fax:
Mailing address:
  • Phone: 509-262-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: DOMINIQUE VENTRIS
Title or Position: OWNER/PROGRAM DIRECTOR
Credential:
Phone: 509-406-3524