Healthcare Provider Details

I. General information

NPI: 1871815977
Provider Name (Legal Business Name): MEMORIAL PHYSICIANS, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 TIETON DR STE 300
YAKIMA WA
98902-3679
US

IV. Provider business mailing address

3800 SUMMITVIEW AVE
YAKIMA WA
98902-2715
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-3946
  • Fax: 509-225-2701
Mailing address:
  • Phone: 509-249-5066
  • Fax: 509-249-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY REED
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 509-248-7849