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2 E Valley Mall Blvd Union Gap WA 98903-1613 | |
(509) 453-1770 | |
(509) 457-4121 |
Full Name | |
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Speciality | Clinic/center |
Location | 2 E Valley Mall Blvd, Union Gap, Washington |
Authorized Official Name and Position | Mathew Mathiesen (CFO) |
Authorized Official Contact | 5098371356 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 719 Sunnyside WA 98944-0719 Ph: (509) 865-2500 | 2 E Valley Mall Blvd Union Gap WA 98903-1613 Ph: (509) 453-1770 |
NPI Number | 1184143588 |
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Provider Enumeration Date | 09/18/2017 |
Last Update Date | 10/10/2024 |
Identifier | Type | State | Issuer |
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1184143588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |