Full Name | |
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Speciality | Family Medicine |
Location | 5 S 14th Ave, Yakima, Washington |
Authorized Official Name and Position | Greg A Swart (OWNER) |
Authorized Official Contact | 5099456205 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
5 S 14th Ave Yakima WA 98902-3101 Ph: (509) 426-2378 | 5 S 14th Ave Yakima WA 98902-3101 Ph: (509) 426-2378 |
NPI Number | 1629365374 |
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Provider Enumeration Date | 07/01/2011 |
Last Update Date | 06/11/2019 |
Medicare PECOS PAC ID | 4082869367 |
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Medicare Enrollment ID | O20130313000347 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629365374 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AP30005978 (Washington) | Primary |
Provider Name | Joseph A Dimeo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205848942 PECOS PAC ID: 1951472315 Enrollment ID: I20080612000724 |
Provider Name | Anne D Tweedy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659395531 PECOS PAC ID: 0547305674 Enrollment ID: I20100301000693 |
Provider Name | Kimberly A Shipley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083128524 PECOS PAC ID: 9537407556 Enrollment ID: I20190215001851 |
Yakima Gastroenterology Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3909 Creekside Loop, Suite 130, Yakima, WA 98902 Phone: 509-248-6616 Fax: 509-248-4983 | |