Active NPI
Yelm Family Medicine, PLLC
- Family Medicine Physician
- Yelm, WA
National Provider Identifier
1053364950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- YELM FAMILY MEDICINE, PLLC
- Practice address
- 201 Tahoma Blvd
Suite 102
Yelm, WA 98597-7735 - Phone
- (360) 458-7761
- Fax
- (360) 458-8316
- NPI assigned
- May 19, 2006
- Last updated
- Jul 31, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brenda E Longmire
- Title
- Manager
- Phone
- (360) 458-7761
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
201 Tahoma Blvd
Suite 102
Yelm, WA 98597-7735
Mailing address
201 Tahoma Blvd SE
Suite 102
Yelm, WA 98597
Phone (360) 458-7761
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62140 | Other | WA | L&I |
| 7068828 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0637291 | Yelm Family Medicine | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
201 Tahoma Blvd
Yelm, WA 98597
Phone (360) 413-8250
201 Tahoma Blvd
Unit 102
Yelm, WA 98597
Phone (360) 458-7761
Practitioners & affiliated clinicians
Practitioners 13
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753920000000",
"number": "1053364950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 TAHOMA BLVD SE",
"address_2": "SUITE 102",
"city": "YELM",
"state": "WA",
"postal_code": "98597",
"telephone_number": "360-458-7761",
"fax_number": "360-458-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 TAHOMA BLVD",
"address_2": "SUITE 102",
"city": "YELM",
"state": "WA",
"postal_code": "985977735",
"telephone_number": "360-458-7761",
"fax_number": "360-458-8316"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YELM FAMILY MEDICINE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A",
"authorized_official_last_name": "LONGMIRE",
"authorized_official_first_name": "BRENDA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "360-458-7761"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "62140",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7068828",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Yelm, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.