Provider Demographics
NPI:1366707283
Name:YAKIMA HEART CENTER AT MEMORIAL
Entity type:Organization
Organization Name:YAKIMA HEART CENTER AT MEMORIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-574-5965
Mailing Address - Street 1:406 S 30TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3713
Mailing Address - Country:US
Mailing Address - Phone:509-248-7715
Mailing Address - Fax:
Practice Address - Street 1:406 S 30TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3713
Practice Address - Country:US
Practice Address - Phone:509-248-7715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAKIMA VALLEY MEMORIAL HOSPITAL ASSN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-06
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center