# YAKIMA VALLEY FARM WORKERS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** YAKIMA VALLEY FARM WORKERS CLINIC
- **Other names:** Mirasol Family Health Center Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285290924
- **Legal business name:** YAKIMA VALLEY FARM WORKERS CLINIC
- **Authorized official:** GLEN DAVIS (COO)
- **Authorized official phone:** (509) 865-6175

## Contact information

- **Practice address:** 589 NW 11TH ST, HERMISTON, OR 97838-6600
- **Practice address phone:** (541) 564-5176
- **Practice address fax:** (541) 567-6860
- **Mailing address:** 2601 COMMERCE LN, YAKIMA, WA 98901-5801
- **Mailing address phone:** (509) 865-6175
- **Mailing address fax:** (509) 865-0840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/17/2019
- **Last updated:** 06/30/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3846586 | NCPDP | OR |