Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 402 S 4th Ave, Yakima, Washington |
Authorized Official Name and Position | Jodi Daly (PRESIDENT/CEO) |
Authorized Official Contact | 5095754084 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 959 Yakima WA 98907-0959 Ph: () - | 402 S 4th Ave Yakima WA 98902 Ph: (509) 575-4084 |
NPI Number | 1588871693 |
---|---|
Provider Enumeration Date | 05/17/2007 |
Last Update Date | 02/16/2024 |
Medicare PECOS PAC ID | 7618875022 |
---|---|
Medicare Enrollment ID | O20200121002552 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588871693 | NPI | - | NPPES |
1986108 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QM2800X | Clinic/center - Methadone | (* (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 | |