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General NPI Number Information
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NPI Number | 1598991481
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Entity Type | Organization
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Legal Business Name | YAKIMA VALLEY FARM WORKER CLINIC
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 518 W 1ST AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1564
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Country | US
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Telephone | 509-865-6901
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Fax |
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Provider Business Mailing Address
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Address Line | 518 W 1ST AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1564
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MARY SIFUENTES
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Credential |
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Telephone | 509-865-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LP00034464
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License Number State | WA
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