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402 N 4th St Ste 300 Yakima WA 98901-2470 | |
(509) 453-9387 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 402 N 4th St, Yakima, Washington |
Authorized Official Name and Position | Juan Carlos Olivares (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5098656175 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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402 N 4th St Ste 300 Yakima WA 98901-2470 Ph: (509) 453-9387 | 402 N 4th St Ste 300 Yakima WA 98901-2470 Ph: (509) 453-9387 |
NPI Number | 1871629501 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1871629501 | NPI | - | NPPES |
1991728 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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 | |