Provider Demographics
NPI:1720523103
Name:PINNACLE HEALTHCARE CENTER, PLLC
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE CENTER, PLLC
Other - Org Name:PINNACLE HEALTHCARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:J G
Authorized Official - Last Name:BHASKARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-248-0497
Mailing Address - Street 1:1460 N 16TH AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7102
Mailing Address - Country:US
Mailing Address - Phone:509-248-0497
Mailing Address - Fax:509-248-4167
Practice Address - Street 1:2309 W. DOLARWAY RD
Practice Address - Street 2:STE. 2
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8087
Practice Address - Country:US
Practice Address - Phone:509-968-5066
Practice Address - Fax:509-968-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039387332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies