Full Name | |
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Speciality | Clinic/Center |
Location | 201 S 6th St, Yakima, Washington |
Authorized Official Name and Position | Rhonda Hauff (COO/CHIEF OPERATIONS OFFICER) |
Authorized Official Contact | 5094544143 |
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 2605 Yakima WA 98907-2605 Ph: () - | 201 S 6th St Yakima WA 98901-2928 Ph: (509) 454-4143 |
NPI Number | 1194379354 |
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Provider Enumeration Date | 07/26/2019 |
Last Update Date | 07/29/2019 |
Medicare PECOS PAC ID | 6709786585 |
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Medicare Enrollment ID | O20191127002103 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194379354 | NPI | - | NPPES |
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 | |