=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669808945
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YAKIMA NEIGHBORHOOD HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2013
-----------------------------------------------------
Last Update Date | 07/19/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 617 SCOON RD
-----------------------------------------------------
City | SUNNYSIDE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98944-1031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-837-8200
-----------------------------------------------------
Fax | 509-837-2919
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2605
-----------------------------------------------------
City | YAKIMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98907-2605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-454-4143
-----------------------------------------------------
Fax | 509-837-2919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | ANITA MONOIAN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 509-574-5550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number | PHARCF60396753
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------