Provider Demographics
NPI:1134176746
Name:YAKIMA VALLEY HEARING AND SPEECH CENTER
Entity type:Organization
Organization Name:YAKIMA VALLEY HEARING AND SPEECH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:509-453-8248
Mailing Address - Street 1:303 S 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3112
Mailing Address - Country:US
Mailing Address - Phone:509-453-8248
Mailing Address - Fax:509-248-9012
Practice Address - Street 1:303 S 12TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3112
Practice Address - Country:US
Practice Address - Phone:509-453-8248
Practice Address - Fax:509-248-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7980709Medicaid
VA9079203Medicaid
WA7098684Medicaid
VA9079203Medicaid