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General NPI Number Information
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NPI Number | 1053364950
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Entity Type | Organization
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Legal Business Name | YELM FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 201 TAHOMA BLVD SUITE 102
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City | YELM
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State | WA
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Zip | 98597-7735
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Country | US
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Telephone | 360-458-7761
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Fax | 360-458-8316
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Provider Business Mailing Address
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Address Line | 201 TAHOMA BLVD SE SUITE 102
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City | YELM
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State | WA
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Zip | 98597
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Country | US
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Telephone | 360-458-7761
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Fax | 360-458-6612
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Authorized Official
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Title or Position | MANAGER
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Name | BRENDA E LONGMIRE
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Credential |
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Telephone | 360-458-7761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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