Provider Demographics
NPI:1801888920
Name:YAKIMA HMA HOME HEALTH LLC
Entity type:Organization
Organization Name:YAKIMA HMA HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATHIESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-837-1379
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:509-575-5093
Mailing Address - Fax:509-454-6537
Practice Address - Street 1:7 S 10TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3318
Practice Address - Country:US
Practice Address - Phone:509-575-5093
Practice Address - Fax:509-837-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9208901Medicaid
WA959055690OtherSUPPLIES
507043Medicare Oscar/Certification