NPIMap

Organization Active NPI

Confederated Tribes & Bands of the Yakama Nation

  • Clinic/Center
  • White Swan, WA
National Provider Identifier
1558574541
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
252-11-2016 Issued in WA
Legal business name
CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION
Practice address
80 Birdsong Lane
White Swan, WA 98952
Phone
(509) 874-2979
Fax
(509) 874-2113
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Ms. Ellen M Swan
Title
Program Manager
Phone
(509) 874-2979

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 252-11-2016 WA Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X WA

Addresses

Primary practice location

80 Birdsong Lane
White Swan, WA 98952

Mailing address

80 Birdsong Lane
White Swan, WA 98952
Phone (509) 874-2979

Other identifiers 1

IdentifierTypeStateIssuer
7086150MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Confederated Tribes and Bands of the Yakama Nation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1558574541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BIRDSONG LANE",
            "city": "WHITE SWAN",
            "state": "WA",
            "postal_code": "98952",
            "telephone_number": "509-874-2979",
            "fax_number": "509-874-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BIRDSONG LANE",
            "city": "WHITE SWAN",
            "state": "WA",
            "postal_code": "98952",
            "telephone_number": "509-874-2979",
            "fax_number": "509-874-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "509-874-2979",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "252-11-2016",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7086150",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Swan, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.