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602 E Nob Hill Blvd Yakima WA 98901-3534 | |
(509) 457-6881 | |
(509) 453-6144 |
Full Name | |
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Speciality | Clinic/Center |
Location | 602 E Nob Hill Blvd, 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) 457-6881 | 602 E Nob Hill Blvd Yakima WA 98901-3534 Ph: (509) 457-6881 |
NPI Number | 1174659890 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 11/01/2022 |
Medicare PECOS PAC ID | 4385541986 |
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Medicare Enrollment ID | O20101004001436 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174659890 | NPI | - | NPPES |
68100 | Other | VA | LABOR AND INDUSTRIES |
7033913 | Medicaid | WA | |
YA0023 | Other | WA | REGENCE BLUE SHIELD |
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 | |