Organization
MEMORIAL PHYSICIANS, PLLC
Active
Other names
Lakeview
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY REED (CHIEF OPERATING OFFICER)
(509) 248-7849
Entity
Organization
Contact information
Practice address
1470 N 16TH AVE, SUITE D, YAKIMA, WA 98902-1381
(509) 574-6000
(509) 225-2714
Mailing address
3800 SUMMITVIEW AVE, YAKIMA, WA 98902-2715
(509) 574-6000
(509) 225-2714
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
602902835
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8890668
MEDICARE
WA
Enumeration date
04/19/2011
Last updated
04/15/2015
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