Organization
SUNNYSIDE FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL JIMENEZ PHYSICIAN ASSISTANT (OWER)
(509) 388-4686
Entity
Organization
Contact information
Practice address
1614 E EDISON AVE STE F, SUNNYSIDE, WA 98944-1668
(509) 388-4686
Mailing address
409 EMERALD AVE, GRANDVIEW, WA 98930-6101
(509) 388-4686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/03/2025
Last updated
11/25/2025
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