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General NPI Number Information
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NPI Number | 1306933940
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Entity Type | Organization
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Legal Business Name | YAKIMA VALLEY MEMORIAL PHYSICIANS
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 2811 TIETON DRIVE
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City | YAKIMA
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State | WA
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Zip | 98902
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Country | US
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Telephone | 509-575-8825
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Fax | 509-577-5056
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Provider Business Mailing Address
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Address Line | PO BOX 9787
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City | YAKIMA
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State | WA
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Zip | 98909
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Country | US
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Telephone | 509-574-3353
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Fax | 509-225-3168
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Authorized Official
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Title or Position | MANAGER, PROVIDER DATA & ENROLLMENT
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Name | KELLY WILLIAMS
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Credential |
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Telephone | 253-459-8009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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