Organization Name: | YAKIMA VALLEY FARM WORKERS CLINIC |
NPI Number: | 1083743538 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUAN CARLOS OLIVARES (EXECUTIVE DIRECTOR) |
Mailing Address: | 201 E Mountain View Ave Ellensburg |
State: | WA US |
Postal Code: | 989263770 |
Phone Number: | 5099622435 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 02/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |