Provider Demographics
NPI:1417131228
Name:YAKIMA VALLEY SURGICAL ASSOC
Entity Type:Organization
Organization Name:YAKIMA VALLEY SURGICAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELERDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-837-7722
Mailing Address - Street 1:500 SOUTH 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-2240
Mailing Address - Country:US
Mailing Address - Phone:509-837-7722
Mailing Address - Fax:509-837-2587
Practice Address - Street 1:500 S 11TH ST
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-2240
Practice Address - Country:US
Practice Address - Phone:509-837-7722
Practice Address - Fax:509-837-2587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018116208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty