| Lincoln Avenue Medical Center | |
|
2205 W Lincoln Ave Yakima WA 98902-2437 | |
| (509) 575-1990 | |
| (509) 575-3398 |
| Full Name | Lincoln Avenue Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2205 W Lincoln Ave, Yakima, Washington |
| Authorized Official Name and Position | Shannon Fernandez (BILLING VP) |
| Authorized Official Contact | 5098656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Avenue Medical Center Po Box 190 Toppenish WA 98948-0190 Ph: (509) 575-1990 | Lincoln Avenue Medical Center 2205 W Lincoln Ave Yakima WA 98902-2437 Ph: (509) 575-1990 |
| NPI Number | 1659407872 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20031223000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659407872 | NPI | - | NPPES |
| 57740 | Other | WA | LABOR AND INDUSTRIES |
| YA0023 | Other | WA | REGENCE BLUE SHIELD |
| 7096951 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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