NPIMap

Organization Active NPI

Memorial Physicians, PLLC

  • Clinic/Center
  • Yakima, WA
National Provider Identifier
1063725851
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD00022161 Issued in WA
Legal business name
MEMORIAL PHYSICIANS, PLLC
Doing business as
Yakima Internal Medicine
Practice address
3003 Tieton Dr
Ste 350
Yakima, WA 98902-3679
Phone
(509) 453-3765
Fax
(509) 225-2709
NPI assigned
Jul 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Authorized official

Name
Timothy Reed
Title
Chief Operating Officer
Phone
(509) 248-7849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD00022161 WA Primary

Addresses

Primary practice location

3003 Tieton Dr
Ste 350
Yakima, WA 98902-3679

Mailing address

3800 Summitview Ave
Yakima, WA 98902-2715
Phone (509) 248-7849

Other identifiers 1

IdentifierTypeStateIssuer
DQ2512OtherWARAILROAD MEDICARE

Other names 1

  • Yakima Internal Medicine Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1063725851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022715",
            "telephone_number": "509-248-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 TIETON DR",
            "address_2": "STE 350",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023679",
            "telephone_number": "509-453-3765",
            "fax_number": "509-225-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "509-248-7849"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD00022161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ2512",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yakima Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.