MEDICARE: DR. PHYLICIA DANIELLE YORGURE M.D.

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
1	208600000X	Surgery Physician	S7041	TX
2	208600000X	Surgery Physician	MD61555498	WA

General Provider Information

NPI Number	:	1649537853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHYLICIA DANIELLE YORGURE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 719
Second Line	:
City	:	SUNNYSIDE
State	:	WA
Zip	:	98944-0719
Country	:	US
Telephone Number	:	509-837-1617
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 VINTAGE VALLEY PKWY STE 200
Second Line	:
City	:	ZILLAH
State	:	WA
Zip	:	98953-9800
Country	:	US
Telephone Number	:	509-314-6565
Fax Number	:	509-314-6564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	03/07/2025

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