NPIMap

Organization Active NPI

Medical Associates of Yakima, LLC

Doing business as Pacific Crest Family Medicine

  • Multi-Specialty Clinic/Center
  • Yakima, WA
National Provider Identifier
1215109368
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
601883477 Issued in WA
Legal business name
MEDICAL ASSOCIATES OF YAKIMA, LLC
Doing business as
Pacific Crest Family Medicine
Practice address
311 S 72ND Ave
Yakima, WA 98908-1661
Phone
(509) 972-1818
Fax
(509) 972-7842
NPI assigned
Mar 28, 2008
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Caroline George
Title
Director of Finance
Phone
(509) 248-7849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 601883477 WA Primary

Addresses

Primary practice location

311 S 72ND Ave
Yakima, WA 98908-1661

Mailing address

PO Box 2947
Yakima, WA 98907-2947
Phone (509) 248-7849

Other identifiers 1

IdentifierTypeStateIssuer
7091168MedicaidWA

Other names 1

  • Pacific Crest Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Yakima LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1215109368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2947",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072947",
            "telephone_number": "509-248-7849",
            "fax_number": "509-248-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S 72ND AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081661",
            "telephone_number": "509-972-1818",
            "fax_number": "509-972-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF YAKIMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "509-248-7849"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WA",
            "license": "601883477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7091168",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Crest Family 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 Jun 20, 2008; 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.