Individual provider Active NPI

Elly McEachern

  • Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1063305803
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP70040212 Issued in WA
Practice address
602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone
(509) 248-3334
NPI assigned
May 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61346113 WA
Registered Nurse 163W00000X 61346113 WA
Nurse Practitioner 363L00000X AP70040212 WA Primary

Addresses

Primary practice location

602 E Nob Hill Blvd
Yakima, WA 98901-3534

Mailing address

5221 78TH Avenue CT W
University Place, WA 98467-1966
Phone (253) 365-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923001748 WA Practitioner - Nurse Practitioner 1658876636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone (509) 248-3334

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61346113WAMDRegistered Nurse
AP70040212WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Sep 8, 2025 Accepting new patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Sep 8, 2025 Accepting new patients

Locations

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

314 S 11th Ave
Ste A
Yakima, WA 98902
Phone (509) 575-0114

602 E Nob Hill Blvd
Yakima, WA 98901
Phone (509) 248-3334

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1063305803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 78TH AVENUE CT W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984671966",
            "telephone_number": "253-365-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEACHERN",
        "first_name": "ELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61346113",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61346113",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP70040212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.