Provider Demographics
NPI:1174864425
Name:ROY S PIERSON, MD PC
Entity Type:Organization
Organization Name:ROY S PIERSON, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-895-7900
Mailing Address - Street 1:3003 TIETON DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3679
Mailing Address - Country:US
Mailing Address - Phone:509-895-7900
Mailing Address - Fax:509-895-7906
Practice Address - Street 1:3003 TIETON DR
Practice Address - Street 2:SUITE 320
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3679
Practice Address - Country:US
Practice Address - Phone:509-895-7900
Practice Address - Fax:509-895-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044568207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty