Organization
YAKIMA RIVER PAIN MANAGEMENT PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY L FAVERO (OWNER/PRESIDENT)
(509) 962-2273
Entity
Organization
Contact information
Practice address
109 S WATER ST, SUITE 2, ELLENSBURG, WA 98926-3061
(509) 962-2273
(509) 962-2270
Mailing address
109 S WATER ST, SUITE 2, ELLENSBURG, WA 98926-3061
(509) 962-2273
(509) 962-2270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2013
Last updated
03/15/2013
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