Organization
LAKE ASPEN PROFESSIONAL GROUP PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE VLAHAKIS M.D. (PRESIDENT)
(509) 575-7750
Entity
Organization
Contact information
Practice address
1460 N 16TH AVE, SUITE G, YAKIMA, WA 98902-7102
(509) 575-7750
(509) 575-7796
Mailing address
1460 N 16TH AVE, SUITE G, YAKIMA, WA 98902-7102
(509) 575-7750
(509) 575-7796
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MD00014780
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7237209
—
WA
Enumeration date
12/21/2011
Last updated
08/29/2012
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