Basic Information
Provider Information
NPI: 1629390059
EntityType: 2
ReplacementNPI:  
OrganizationName: PREMIER WOMENS HEALTH OF YAKIMA PLLC
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Mailing Information
Address1: 3003 TIETON DR
Address2: SUITE 200
City: YAKIMA
State: WA
PostalCode: 989023679
CountryCode: US
TelephoneNumber: 5094542229
FaxNumber: 5094547979
Practice Location
Address1: 3003 TIETON DR
Address2: SUITE 200
City: YAKIMA
State: WA
PostalCode: 989023679
CountryCode: US
TelephoneNumber: 5094542229
FaxNumber: 5094547979
Other Information
ProviderEnumerationDate: 02/26/2010
LastUpdateDate: 05/21/2010
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AuthorizedOfficialLastName: PIERSON
AuthorizedOfficialFirstName: CAROLYN
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: BILLING REP
AuthorizedOfficialTelephone: 5099722357
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IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD00043447WAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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