NPIMap

Organization Active NPI

Cascade Family Medical Clinic Inc PS

  • Family Medicine Physician
  • Centralia, WA
National Provider Identifier
1376536136
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
600344469 Issued in WA
Legal business name
CASCADE FAMILY MEDICAL CLINIC INC PS
Practice address
1740 Cooks Hill Rd
Centralia, WA 98531-9071
Phone
(360) 736-7623
Fax
(360) 736-4074
NPI assigned
Aug 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Christopher L Yarter, MD
Title
President
Phone
(360) 736-7623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 600344469 WA Primary

Addresses

Primary practice location

1740 Cooks Hill Rd
Centralia, WA 98531-9071

Mailing address

1740 Cooks Hill Rd
Centralia, WA 98531-9071
Phone (360) 736-7623

Other identifiers 2

IdentifierTypeStateIssuer
7089634MedicaidWA
0031980OtherWAL & I

National Provider Directory

National Provider Directory

Locations

1740 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 736-7623

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1376536136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319071",
            "telephone_number": "360-736-7623",
            "fax_number": "360-736-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319071",
            "telephone_number": "360-736-7623",
            "fax_number": "360-736-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE FAMILY MEDICAL CLINIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "YARTER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-736-7623",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "600344469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7089634",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0031980",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.