| Jeffrey Hamilton Licht, MD | |
|
315 Holton Ave, Suite 100, Yakima, WA 98902-3254 | |
| (509) 248-6292 | |
| (509) 248-9134 |
| Full Name | Jeffrey Hamilton Licht |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Nephrology |
| Location | 315 Holton Ave, Yakima, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770642274 | NPI | - | NPPES |
| 1301506 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | 0021581 (Washington) | Primary |
| Entity Name | J. Hamilton Licht, M.d., P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306905138 PECOS PAC ID: 0648202242 Enrollment ID: O20050902000669 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Hamilton Licht, MD 315 Holton Ave, Suite 100, Yakima, WA 98902-3254 Ph: (509) 248-6292 | Jeffrey Hamilton Licht, MD 315 Holton Ave, Suite 100, Yakima, WA 98902-3254 Ph: (509) 248-6292 |
Daniel Doornink, Nephrology Medicare: Not Enrolled in Medicare Practice Location: 602 E Nob Hill Blvd, Yakima, WA 98901 Phone: 509-248-3334 Fax: 509-453-6144 | |
Robert M Williams, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 3909 Creekside Loop, Suite 130, Yakima, WA 98902 Phone: 509-248-6616 Fax: 509-248-4983 | |
Erik Albert Monick, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 406 S 30th Ave, Suite 101, Yakima, WA 98902 Phone: 509-248-7715 | |
George J Hotchko, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 3003 Tieton Dr, Suite 320, Yakima, WA 98902 Phone: 509-452-3765 Fax: 509-452-3435 | |
Sajal Kumar, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 315 Holton Ave, Suite 100, Yakima, WA 98902 Phone: 509-248-6292 Fax: 509-248-9134 | |
Dr. Rachana Mandru, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 406 S 30th Ave Ste 101, Yakima, WA 98902 Phone: 509-248-7715 | |
Edwin Llamas, Nephrology Medicare: Accepting Medicare Assignments Practice Location: 602 E Nob Hill Blvd, Yakima, WA 98901 Phone: 509-248-3334 |