Provider Demographics
NPI:1154792265
Name:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-403-7355
Mailing Address - Street 1:2811 TIETON DR
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3761
Mailing Address - Country:US
Mailing Address - Phone:509-574-5995
Mailing Address - Fax:509-249-5202
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:509-574-5951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA397011023332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6001309Medicaid
WA0474340003Medicare UPIN