Organization
YAKIMA VALLEY PROFESSIONAL SERVICES ON TIETON, PC
Active
Other names
Pacific Crest Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JIM SIMMONS (DIRECTOR OF FINANCE)
(509) 248-7849
Entity
Organization
Contact information
Practice address
311 S. 72ND AVE, YAKIMA, WA 98908
(509) 972-1818
(509) 972-7842
Mailing address
PO BOX 2947, YAKIMA, WA 98907-2947
(509) 248-7849
(509) 249-5042
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD00027321
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7091168
—
WA
Enumeration date
07/01/2006
Last updated
08/19/2010
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