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1806 W Lincoln Ave Yakima WA 98902-2473 | |
(509) 452-4520 | |
(509) 452-5224 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1806 W Lincoln Ave, Yakima, Washington |
Authorized Official Name and Position | Angela Gonzalez (CEO) |
Authorized Official Contact | 5094946700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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501 S 5th Ave Yakima WA 98902-3550 Ph: (509) 494-6700 | 1806 W Lincoln Ave Yakima WA 98902-2473 Ph: (509) 452-4520 |
NPI Number | 1700097706 |
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Provider Enumeration Date | 05/24/2007 |
Last Update Date | 07/29/2020 |
Medicare PECOS PAC ID | 4183536931 |
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Medicare Enrollment ID | O20031022000027 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700097706 | NPI | - | NPPES |
7118276 | Medicaid | WA | |
31820 | Other | WA | LABOR & INDUSTRIES |
8932819 | Other | WA | CRIME VICTIM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
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 | |