Provider Demographics
NPI:1578708921
Name:CEDAR RIVER CLINICS
Entity Type:Organization
Organization Name:CEDAR RIVER CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-728-9036
Mailing Address - Street 1:106 E E ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-2312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:106 E E ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2312
Practice Address - Country:US
Practice Address - Phone:509-575-6473
Practice Address - Fax:509-575-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60064195261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical