Provider Demographics
NPI:1396010815
Name:GEORGE S GARFEIN MD INC PS
Entity Type:Organization
Organization Name:GEORGE S GARFEIN MD INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARFEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-965-1050
Mailing Address - Street 1:1021 S 40TH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3858
Mailing Address - Country:US
Mailing Address - Phone:509-965-1050
Mailing Address - Fax:
Practice Address - Street 1:1021 S 40TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3858
Practice Address - Country:US
Practice Address - Phone:509-965-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGE S GAFEIN MD INC PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-16
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD12618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1293406Medicaid
WAG000119109Medicare PIN
WAE06554Medicare UPIN