Provider Demographics
NPI:1922326578
Name:YAKIMA WORKER CARE
Entity Type:Organization
Organization Name:YAKIMA WORKER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMATIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-575-2949
Mailing Address - Street 1:409 S 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3114
Mailing Address - Country:US
Mailing Address - Phone:509-575-2949
Mailing Address - Fax:509-575-5743
Practice Address - Street 1:409 S 12TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3114
Practice Address - Country:US
Practice Address - Phone:509-575-2949
Practice Address - Fax:509-575-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60151757261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0262551OtherLNI NUMBER