Provider Demographics
NPI:1629574264
Name:NEWLEAF HEALTHCARE PC
Entity Type:Organization
Organization Name:NEWLEAF HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-571-1300
Mailing Address - Street 1:4702 SUMMITVIEW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-6001
Mailing Address - Country:US
Mailing Address - Phone:509-571-1300
Mailing Address - Fax:877-334-1891
Practice Address - Street 1:4702 SUMMITVIEW AVE STE 102
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908
Practice Address - Country:US
Practice Address - Phone:509-571-1300
Practice Address - Fax:877-334-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604097030261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service