Provider Demographics
NPI:1669808945
Name:YAKIMA NEIGHBORHOOD HEALTH SERVICES
Entity type:Organization
Organization Name:YAKIMA NEIGHBORHOOD HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:509-574-5550
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:509-837-2919
Practice Address - Street 1:617 SCOON RD
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-1031
Practice Address - Country:US
Practice Address - Phone:509-837-8200
Practice Address - Fax:509-837-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WAPHARCF603967533336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142484OtherPK