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2205 W Lincoln Ave Yakima WA 98902-2437 | |
(509) 575-1990 | |
(509) 575-3398 |
Full Name | |
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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 |
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Po Box 190 Toppenish WA 98948-0190 Ph: (509) 575-1990 | 2205 W Lincoln Ave Yakima WA 98902-2437 Ph: (509) 575-1990 |
NPI Number | 1659407872 |
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Provider Enumeration Date | 02/23/2007 |
Last Update Date | 01/19/2023 |
Medicare PECOS PAC ID | 4385541986 |
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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 |
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 | |