NPIMap

Organization Active NPI

Yakima Valley Farm Workers Clinic

Doing business as 11TH Avenue Family Medicine Clinic

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
National Provider Identifier
1033677307
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
11TH Avenue Family Medicine Clinic
Practice address
314 S 11TH Ave
Yakima, WA 98902-3212
Phone
(509) 902-8585
Fax
(509) 902-2030
NPI assigned
Mar 6, 2019
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christine Trotter
Title
Chief Executive Officer
Phone
(508) 865-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

314 S 11TH Ave
Yakima, WA 98902-3212

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 865-6175

Other identifiers 1

IdentifierTypeStateIssuer
600304660-001-0040OtherWASTATE BUSINESS LICENSE

Other names 1

  • 11TH AVENUE FAMILY MEDICINE CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211000663 WA Part B Supplier - Clinic/Group Practice 4385541986 Receives reassigned benefits from 321 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wapato, WA; Yakima, WA; Ellensburg, WA; Toppenish, WA; Grandview, WA; Granger, WA; Kennewick, WA; Pasco, WA…
O20200929000541 WA Part A Provider - Federally Qualified Health Center (FQHC) 4385541986 Practice locations: Yakima, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033677307. Details of each certification follow.

Federally qualified health center certification: CCN 941080

Legal name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
11TH AVENUE FAMILY MEDICINE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 24, 2020
Last certification
Sep 24, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1978 in WA
Enrollment address
314 S 11TH Ave
Ste a
Yakima, WA 98902-3212

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2163829Yvfwc - 11TH Ave Family Medical Clinic314 S 11TH Ave Ste a, Yakima, WA 98902Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

115 Sunnyside Ave
Ste A
Granger, WA 98932
Phone (509) 865-6450

918 E Mead Ave
Yakima, WA 98903
Phone (509) 453-1344

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Cerna Individual Corporate DirectorBoard Memeber May 1, 2024
Thomas Sanchez Individual Corporate DirectorBoard Memeber May 1, 2024
Thomas Sak Individual Corporate DirectorBoard Member Jan 1, 1983
Carla Alejandra Castaneda Individual Corporate DirectorBoard Memeber Mar 26, 2026
Lorenzo Cuevas Individual Corporate DirectorBoard Member Jan 10, 2010
Pam Cleaver Individual Corporate DirectorBoard Memeber Jan 1, 2023
Virginia Santillanes Individual Corporate DirectorBoard Member Jan 1, 1987
Sheila Robertson Individual Corporate OfficerBilling Supervisor Jan 1, 2020
Irene Taylor Individual Corporate DirectorBoard Member Aug 1, 2019
Martin Torres Individual Corporate DirectorBoard Member Jan 1, 1997
Christine Trotter Individual Corporate OfficerCeo Feb 17, 2020
W-2 Managing EmployeeCeo Feb 17, 2020
Roberto Alvizo Individual Corporate DirectorBoard Member Jan 1, 2014
Patricia Myers Individual Corporate DirectorBoard Member Jan 1, 2007
Adrian Ochoa Individual Corporate DirectorBoard Memeber May 1, 2021

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lancaster Family Health Center at LancasterSalem, OR, CCN 381971 Federally qualified health center Operational/Managerial Control Jan 9, 2017
Coastal Family Health CenterAstoria, OR, CCN 931016 Federally qualified health center Operational/Managerial Control Mar 1, 2017
Miramar Health Center KennewickKennewick, WA, CCN 941124 Federally qualified health center Operational/Managerial Control Mar 25, 2021

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1033677307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-865-6175",
            "fax_number": "509-865-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S 11TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023212",
            "telephone_number": "509-902-8585",
            "fax_number": "509-902-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "508-865-6175"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BUSINESS LICENSE",
            "identifier": "600304660-001-0040",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "11TH AVENUE FAMILY MEDICINE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "11TH AVENUE FAMILY MEDICINE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.