Provider Demographics
NPI:1457560351
Name:YAKIMA NEIGHBORHOOD HEALTH SERVICES
Entity Type:Organization
Organization Name:YAKIMA NEIGHBORHOOD HEALTH SERVICES
Other - Org Name:NEIGHBORHOOD CONNECTIONS MEDICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRIMARY CARE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-454-4143
Mailing Address - Street 1:PO BOX 2605
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2605
Mailing Address - Country:US
Mailing Address - Phone:509-454-4143
Mailing Address - Fax:509-454-3651
Practice Address - Street 1:102 S NACHES AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2947
Practice Address - Country:US
Practice Address - Phone:509-834-2098
Practice Address - Fax:509-454-4115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAKIMA NEIGHBORHOOD HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-21
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA501899Medicare ID - Type UnspecifiedUGS