Organization
YAKIMA SURGICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN K BOUCHER MD (PHYSICIAN)
(509) 248-6080
Entity
Organization
Contact information
Practice address
111 S 11TH AVE, SUITE 223, YAKIMA, WA 98902-3242
(509) 248-6080
(509) 248-9964
Mailing address
PO BOX 2947, YAKIMA, WA 98907-2947
(509) 248-7849
(509) 249-5042
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7080187
—
WA
Enumeration date
07/01/2006
Last updated
11/21/2007
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