Provider Demographics
NPI:1790964294
Name:RHEUMATOLOGY NORTHWEST, PLLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY NORTHWEST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-575-3946
Mailing Address - Street 1:3902 CREEKSIDE LOOP
Mailing Address - Street 2:SUITE 120
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4876
Mailing Address - Country:US
Mailing Address - Phone:509-248-4066
Mailing Address - Fax:
Practice Address - Street 1:3902 CREEKSIDE LOOP
Practice Address - Street 2:SUITE 120
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4876
Practice Address - Country:US
Practice Address - Phone:509-248-4066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WENDY EIDER, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00022000207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1079334Medicaid
WAA06549Medicare UPIN
WAAB36213Medicare PIN
WA1079334Medicaid