Provider Demographics
NPI:1548416258
Name:YAKIMA OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:YAKIMA OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-575-7500
Mailing Address - Street 1:307 S 12TH AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3100
Mailing Address - Country:US
Mailing Address - Phone:509-575-7500
Mailing Address - Fax:509-575-0333
Practice Address - Street 1:307 S 12TH AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3100
Practice Address - Country:US
Practice Address - Phone:509-575-7500
Practice Address - Fax:509-575-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty