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Organization

CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELLEN M SWAN (PROGRAM MANAGER)
(509) 874-2979
Entity
Organization

Contact information

Practice address
80 BIRDSONG LANE, WHITE SWAN, WA 98952
(509) 874-2979
(509) 874-2113
Mailing address
80 BIRDSONG LANE, WHITE SWAN, WA 98952
(509) 874-2979
(509) 874-2113

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
252-11-2016
WA
363A00000X
Physician Assistant
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7086150
WA
Enumeration date
05/07/2007
Last updated
07/14/2009
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