Basic Information
Provider Information
NPI: 1457560351
EntityType: 2
ReplacementNPI:  
OrganizationName: YAKIMA NEIGHBORHOOD HEALTH SERVICES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NEIGHBORHOOD CONNECTIONS MEDICAL
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2605
Address2:  
City: YAKIMA
State: WA
PostalCode: 989072605
CountryCode: US
TelephoneNumber: 5094544143
FaxNumber: 5094543651
Practice Location
Address1: 102 S NACHES AVE
Address2:  
City: YAKIMA
State: WA
PostalCode: 989012947
CountryCode: US
TelephoneNumber: 5098342098
FaxNumber: 5094544115
Other Information
ProviderEnumerationDate: 05/21/2007
LastUpdateDate: 07/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HAUFF
AuthorizedOfficialFirstName: RHONDA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRIMARY CARE ADMINISTRATOR
AuthorizedOfficialTelephone: 5094544143
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: YAKIMA NEIGHBORHOOD HEALTH SERVICES
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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