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General NPI Number Information
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NPI Number | 1649537853
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Entity Type | Individual
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Provider Name | PHYLICIA DANIELLE YORGURE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 915 VINTAGE VALLEY PKWY STE 200
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City | ZILLAH
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State | WA
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Zip | 98953-9800
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Country | US
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Telephone | 509-314-6565
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Fax | 509-314-6564
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | SUNNYSIDE
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State | WA
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Zip | 98944-0719
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Country | US
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Telephone | 509-837-1617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | S7041
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD61555498
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License Number State | WA
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