Organization
MEMORIAL PRACTICE MANAGEMENT, LLC
Active
Other names
Pacific Crest Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JIM W SIMMONS (CHIEF FINANCIAL OFFICER)
(509) 248-7849
Entity
Organization
Contact information
Practice address
311 S 72ND AVE, YAKIMA, WA 98908-1661
(509) 972-1818
(509) 972-7842
Mailing address
PO BOX 2947, YAKIMA, WA 98907-2947
(509) 248-7849
(509) 248-8291
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7091168
—
WA
Enumeration date
04/01/2009
Last updated
04/01/2009
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