Yakima Medical Clinic Inc Pc | |
310 Holton Ave Yakima WA 98902 | |
(509) 452-2508 | |
(509) 452-7316 |
Full Name | Yakima Medical Clinic Inc Pc |
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Speciality | Preferred Provider Organization |
Location | 310 Holton Ave, Yakima, Washington |
Authorized Official Name and Position | T Kent Vye (PRESIDENT) |
Authorized Official Contact | 5094522508 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Yakima Medical Clinic Inc Pc 310 Holton Ave Yakima WA 98902 Ph: (509) 452-2508 | Yakima Medical Clinic Inc Pc 310 Holton Ave Yakima WA 98902 Ph: (509) 452-2508 |
NPI Number | 1316079585 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 10/15/2008 |
Medicare PECOS PAC ID | 8224920996 |
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Medicare Enrollment ID | O20040326001178 |
Identifier | Type | State | Issuer |
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1316079585 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 0P00001175 (Washington) | Secondary |
305R00000X | Preferred Provider Organization | 0P00001175 (Washington) | Primary |
Provider Name | Theodore Kent Vye |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609894278 PECOS PAC ID: 6305733841 Enrollment ID: I20100924000129 |
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 | |