Healthcare Provider Details

I. General information

NPI: 1275478372
Provider Name (Legal Business Name): THE YAKIMA CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S 11TH AVE STE 42
YAKIMA WA
98902-3221
US

IV. Provider business mailing address

210 S 11TH AVE STE 42
YAKIMA WA
98902-3221
US

V. Phone/Fax

Practice location:
  • Phone: 509-316-2003
  • Fax: 509-495-1151
Mailing address:
  • Phone: 509-316-2003
  • Fax: 509-495-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AKIRA KOBAYASHI
Title or Position: CEO
Credential: MD
Phone: 509-509-5797