Basic Information
| Provider Information | |||||||||
| NPI: | 1285709568 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YORK | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3900 S ZINTEL WAY | ||||||||
| Address2: | |||||||||
| City: | KENNEWICK | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993375092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099423627 | ||||||||
| FaxNumber: | 5099422268 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 GOETHALS DRIVE 1ST FLOOR | ||||||||
| Address2: | KADLEC CLINICS INFECTIOUS DISEASE | ||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993523304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099422360 | ||||||||
| FaxNumber: | 5099422239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 04/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 2033 | ME | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208M00000X | 2033 | ME | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RI0200X | OP00002347 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 0236959 | 01 | WA | LABOR & INDUSTRIES | OTHER | 432768999 | 05 | ME | MEDICAID |