Healthcare Provider Details

I. General information

NPI: 1255415824
Provider Name (Legal Business Name): GREGORY D. SAWYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 TIETON DR
YAKIMA WA
98902-3761
US

IV. Provider business mailing address

PO BOX 9787
YAKIMA WA
98909-0787
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-8302
  • Fax:
Mailing address:
  • Phone: 509-574-3350
  • Fax: 509-225-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00025976
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: