Organization
YAKAMA NATION CCAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY A SHIRLEY (ADMIN. ASSISTANT)
(509) 865-5121
Entity
Organization
Contact information
Practice address
20 GUNNYON RD, TOPPENISH, WA 98948
(509) 865-5121
(509) 865-4333
Mailing address
P.O. BOX 151, 20 GUNNYON ROAD, TOPPENISH, WA 98948
(509) 865-5121
(509) 865-4333
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
CP 00001456
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CP 00001456
—
WA
Enumeration date
11/01/2012
Last updated
11/01/2012
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