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NPI Code Detail

MEDICARE: YAKIMA VALLEY FARM WORKERS CLINIC

MEDICARE: YAKIMA VALLEY FARM WORKERS CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyCF5142WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14924280OTHERWANCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508957572
Entity Type Code : Organization
Provider Name (Legal Business Name) : YAKIMA VALLEY FARM WORKERS CLINIC
Provider Business Mailing Address
First Line : 602 E NOB HILL BLVD
Second Line :
City : YAKIMA
State : WA
Zip : 98901-3534
Country : US
Telephone Number : 509-865-6175
Fax Number : 509-865-0840
Provider Business Practice Location Address
First Line : 602 E NOB HILL BLVD
Second Line :
City : YAKIMA
State : WA
Zip : 98901-3534
Country : US
Telephone Number : 509-452-8325
Fax Number : 509-457-3867
Authorized Official
Title or Position : COO
Name : GLEN DAVIS
Credential :
Telephone Number : 509-865-6175
Provider Enumeration Date : 09/27/2006
Last Update Date : 06/30/2023

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1437261179 — DR. ERNEST OJI KANU M.D.
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1134213457 — NEIL L BARG MD
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1861586182 — CAROLINE CLARK ARNP
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Directions to “YAKIMA VALLEY FARM WORKERS CLINIC ” Practice Location

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