Provider Demographics
NPI:1649537853
Name:YORGURE, PHYLICIA DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:PHYLICIA
Middle Name:DANIELLE
Last Name:YORGURE
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:PHYLICIA
Other - Middle Name:D
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0719
Mailing Address - Country:US
Mailing Address - Phone:509-837-1617
Mailing Address - Fax:
Practice Address - Street 1:915 VINTAGE VALLEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ZILLAH
Practice Address - State:WA
Practice Address - Zip Code:98953-9800
Practice Address - Country:US
Practice Address - Phone:509-314-6565
Practice Address - Fax:509-314-6564
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7041208600000X, 208600000X
WAMD61555498208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery