| Ppgwni | |
|
1117 Tieton Dr Yakima WA 98902-3835 | |
| (866) 904-7721 | |
| (509) 248-3644 |
| Full Name | Ppgwni |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1117 Tieton Dr, Yakima, Washington |
| Authorized Official Name and Position | Kim A. Nelson (VP OF FINANCE) |
| Authorized Official Contact | 8669047721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppgwni 1117 Tieton Dr Yakima WA 98902-3835 Ph: (866) 904-7721 | Ppgwni 1117 Tieton Dr Yakima WA 98902-3835 Ph: (866) 904-7721 |
| NPI Number | 1477708469 |
|---|---|
| Provider Enumeration Date | 11/18/2008 |
| Last Update Date | 04/08/2025 |
| Certification Date | 04/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477708469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
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