| NAME |
YAKIMA CBOC |
| STATE |
WASHINGTON |
| STREET ADDR. 1 |
1211 AHTANUM RIDGE DR |
| CITY |
UNION GAP |
| ZIP |
98903-9998 |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
UNION GAP VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1992745723
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
687HA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 717 FRUITVALE BLVD
- CITY (CHANGED FROM): YAKIMA
- STATE (CHANGED FROM): WASHINGTON
- ZIP (CHANGED FROM): 98902-1465
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1992745723
-
- CODING SYSTEM: VASTANUM
- ID: 687HA
-
- CODING SYSTEM: CLIA
- ID: 50D1016948
|
