Healthcare Provider Details

I. General information

NPI: 1740089549
Provider Name (Legal Business Name): COMMUNITY HEALTH OF CENTRAL WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S 12TH AVE
YAKIMA WA
98902-3115
US

IV. Provider business mailing address

501 S 5TH AVE
YAKIMA WA
98902-3550
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-0114
  • Fax: 509-575-0808
Mailing address:
  • Phone: 509-853-1082
  • Fax: 509-573-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANGELA GONZALEZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 509-494-6700