Provider Demographics
NPI:1629390059
Name:PREMIER WOMENS HEALTH OF YAKIMA PLLC
Entity Type:Organization
Organization Name:PREMIER WOMENS HEALTH OF YAKIMA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REP
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-972-2357
Mailing Address - Street 1:3003 TIETON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3679
Mailing Address - Country:US
Mailing Address - Phone:509-454-2229
Mailing Address - Fax:509-454-7979
Practice Address - Street 1:3003 TIETON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3679
Practice Address - Country:US
Practice Address - Phone:509-454-2229
Practice Address - Fax:509-454-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty