Healthcare Provider Details

I. General information

NPI: 1760569701
Provider Name (Legal Business Name): PALMER P WRIGHT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CREEKSIDE LOOP
YAKIMA WA
98902-4882
US

IV. Provider business mailing address

3800 SUMMITVIEW AVE
YAKIMA WA
98902-2715
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-1000
  • Fax: 509-575-0333
Mailing address:
  • Phone: 509-249-5066
  • Fax: 509-249-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberOP00001051
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: