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General NPI Number Information
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NPI Number | 1023200292
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Entity Type | Organization
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Legal Business Name | CONFEDERATED TRIBES AND BANDS OF THE YAKAMA NATION
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 401 BUSTER ROAD
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City | TOPPENISH
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State | WA
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Zip | 98948
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Country | US
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Telephone | 509-874-2979
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Fax | 509-874-2113
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Provider Business Mailing Address
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Address Line | 401 FORD ROAD
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City | TOPPENISH
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State | WA
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Zip | 98948
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Country | US
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Telephone | 509-865-5121
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Fax | 509-874-2113
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | ELLEN M SWAN
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Credential |
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Telephone | 509-874-2979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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