Active NPI
SHC Medical Center - Yakima
- Cardiovascular Disease Physician
- Yakima, WA
National Provider Identifier
1255844163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- SHC MEDICAL CENTER - YAKIMA
- Practice address
- 1005 W Walnut St Ste 120
Yakima, WA 98902-3360 - Phone
- (509) 454-6545
- Fax
- (509) 454-6544
- NPI assigned
- Nov 14, 2017
- 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
- Mathew Mathiesen
- Title
- Cfo
- Phone
- (509) 837-1655
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
1005 W Walnut St Ste 120
Yakima, WA 98902-3360
Mailing address
PO Box 719
Sunnyside, WA 98944-0719
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728518400000",
"number": "1255844163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 719",
"city": "SUNNYSIDE",
"state": "WA",
"postal_code": "989440719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 W WALNUT ST STE 120",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023360",
"telephone_number": "509-454-6545",
"fax_number": "509-454-6544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHC MEDICAL CENTER - YAKIMA",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-14",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A",
"authorized_official_last_name": "MATHIESEN",
"authorized_official_first_name": "MATHEW",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "509-837-1655"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.