Provider Demographics
NPI:1295377299
Name:PINNACLE SLEEP AND WAKE DISORDERS CENTER,PLLC
Entity Type:Organization
Organization Name:PINNACLE SLEEP AND WAKE DISORDERS CENTER,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-961-3849
Mailing Address - Street 1:24 BURNING TREE DR
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-1576
Mailing Address - Country:US
Mailing Address - Phone:509-961-3849
Mailing Address - Fax:509-426-2160
Practice Address - Street 1:354 CHARDONNAY AVE
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-9545
Practice Address - Country:US
Practice Address - Phone:507-737-1447
Practice Address - Fax:509-737-1553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies