| Dental | |
|
12 S 8th St Yakima WA 98901-3020 | |
| (509) 454-4143 | |
| (509) 454-3651 |
| Full Name | Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 12 S 8th St, Yakima, Washington |
| Authorized Official Name and Position | Rhonda Hauff (PRIMARY CARE ADMINISTRATOR) |
| Authorized Official Contact | 5094544143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Po Box 2605 Yakima WA 98907-2605 Ph: (509) 454-4143 | Dental 12 S 8th St Yakima WA 98901-3020 Ph: (509) 454-4143 |
| NPI Number | 1467599480 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 07/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467599480 | NPI | - | NPPES |
| 5022033 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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