Healthcare Provider Details
I. General information
NPI: 1053373480
Provider Name (Legal Business Name): YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2811 TIETON DR
YAKIMA WA
98902-3761
US
IV. Provider business mailing address
P.O. BOX 5299 MS: 820-5-PCO
YAKIMA WA
98415-0299
US
V. Phone/Fax
- Phone: 509-575-8000
- Fax: 509-574-5800
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | 3500436 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | H-058 |
| License Number State | WA |
VIII. Authorized Official
Name:
WILLIAM
GLENN
ROBERTSON
Title or Position: CEO
Credential:
Phone: 253-403-1272