Organization
CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN M SWAN (PROGRAM MANAGER)
(509) 865-5121
Entity
Organization
Contact information
Practice address
401 BUSTER RD, TOPPENISH, WA 98948-9792
(509) 865-2102
(509) 865-8995
Mailing address
80 BIRDSONG LANE, WHITE SWAN, WA 98952
(509) 865-5121
(509) 874-2113
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
—
—
261QD0000X
Dental Clinic/Center
Primary
DS-091445-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5400171
—
WA
Enumeration date
08/13/2007
Last updated
07/09/2009
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