Healthcare Provider Details

I. General information

NPI: 1477539997
Provider Name (Legal Business Name): YAKIMA ORTHOTICS AND PROSTHETICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 06/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S 9TH AVE
YAKIMA WA
98902-3516
US

IV. Provider business mailing address

313 S 9TH AVE
YAKIMA WA
98902-3516
US

V. Phone/Fax

Practice location:
  • Phone: 509-248-8040
  • Fax: 509-248-8709
Mailing address:
  • Phone: 509-248-8040
  • Fax: 509-248-8709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number602349936
License Number StateWA

VIII. Authorized Official

Name: MR. ANDREW D LAMBERT
Title or Position: OWNER
Credential: CPO
Phone: 509-248-8040