Healthcare Provider Details

I. General information

NPI: 1447637210
Provider Name (Legal Business Name): EMILY RACHEL KOBAYASHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY RACHEL MITCHELL

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
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: 509-509-5790
  • Fax:
Mailing address:
  • Phone: 509-509-5790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD60954999
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: