NPIMap

Organization Active NPI

Memorial Physicians, PLLC

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1538429386
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL PHYSICIANS, PLLC
Doing business as
Lake Aspen Campus
Practice address
1470 N 16TH Ave
Yakima, WA 98902-1381
Phone
(509) 248-3263
Fax
(509) 225-2702
NPI assigned
May 25, 2012
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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1470 N 16TH Ave
Yakima, WA 98902-1381

Mailing address

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

Other names 1

  • Lake Aspen Campus 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": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1538429386",
    "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": "1470 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021381",
            "telephone_number": "509-248-3263",
            "fax_number": "509-225-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Aspen Campus",
            "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.