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314 S 11th Ave Yakima WA 98902-3212 | |
(509) 902-8585 | |
(509) 902-2030 |
Full Name | |
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Speciality | Clinic/Center |
Location | 314 S 11th Ave, Yakima, Washington |
Authorized Official Name and Position | Shannon Fernandez (VP OF BILLING) |
Authorized Official Contact | 5088656175 |
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) 865-6175 | 314 S 11th Ave Yakima WA 98902-3212 Ph: (509) 902-8585 |
NPI Number | 1033677307 |
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Provider Enumeration Date | 03/06/2019 |
Last Update Date | 11/01/2022 |
Medicare PECOS PAC ID | 4385541986 |
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Medicare Enrollment ID | O20200929000541 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033677307 | NPI | - | NPPES |
600304660-001-0040 | Other | WA | STATE BUSINESS LICENSE |
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 | |