NPIMap

Organization Active NPI

Yakima Valley Farm Workers Clinic

Doing business as Lincoln Avenue Medical Center

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
National Provider Identifier
1659407872
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
Lincoln Avenue Medical Center
Practice address
2205 W Lincoln Ave
Yakima, WA 98902-2437
Phone
(509) 575-1990
Fax
(509) 575-3398
NPI assigned
Feb 23, 2007
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
YAKIMA VALLEY FARM WORKERS CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Christine Trotter
Title
Chief Executive Officer
Phone
(509) 865-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2205 W Lincoln Ave
Yakima, WA 98902-2437

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 575-1990

Other identifiers 3

IdentifierTypeStateIssuer
YA0023OtherWAREGENCE BLUE SHIELD
7096951MedicaidWA
57740OtherWALABOR AND INDUSTRIES

Other names 1

  • Lincoln Avenue Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031223000469 WA Part A Provider - Federally Qualified Health Center (FQHC) 4385541986 Practice locations: Yakima, WA
O20040211000663 WA Part B Supplier - Clinic/Group Practice 4385541986 Receives reassigned benefits from 321 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wapato, WA; Yakima, WA; Ellensburg, WA; Toppenish, WA; Grandview, WA; Granger, WA; Kennewick, WA; Pasco, WA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659407872. Details of each certification follow.

Federally qualified health center certification: CCN 501859

Legal name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
LINCOLN AVENUE MEDICAL DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 17, 2001
Last certification
Apr 17, 2001
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Feb 28, 1978 in WA
Enrollment address
2205 W Lincoln Ave
Yakima, WA 98902-2437

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2059567Yvfwc Lincoln Ave Medical Dental Center2205 W Lincoln Ave, Yakima, WA 98902Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Fernando Dietsch MD

Locations

5109 Summitview Ave
Yakima, WA 98908
Phone (509) 317-8520

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sandra April Individual Corporate Director Feb 15, 2005
Thomas Sak Individual Corporate Director Feb 15, 2005
Jose Alberto Nunez Individual Corporate Director Feb 15, 2010
Lorenzo Cuevas Individual Corporate Director Feb 15, 2005
Juan Carlos Olivares Individual Corporate OfficerCeo Feb 3, 1986
Corporate DirectorCeo Feb 27, 2004
W-2 Managing EmployeeCeo Feb 3, 1986
Maria Perez Individual Corporate Director May 15, 2005
Virginia Santillanes Individual Corporate Director Feb 15, 2005
Martin Torres Individual Corporate Director Feb 15, 2005
Alfredo Aceves Individual Corporate Director Feb 15, 2010
Christine Trotter Individual Corporate OfficerCfo Feb 17, 2020
Corporate DirectorCfo Feb 17, 2020
Dina Bejar Individual Corporate OfficerVP of Billing Apr 1, 1990
Patricia Myers Individual Corporate Director Feb 15, 2005

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lancaster Family Health Center at LancasterSalem, OR, CCN 381971 Federally qualified health center Operational/Managerial Control Jan 9, 2017
Coastal Family Health CenterAstoria, OR, CCN 931016 Federally qualified health center Operational/Managerial Control Mar 1, 2017
Miramar Health Center KennewickKennewick, WA, CCN 941124 Federally qualified health center Operational/Managerial Control Mar 25, 2021

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1659407872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-575-1990",
            "fax_number": "509-575-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022437",
            "telephone_number": "509-575-1990",
            "fax_number": "509-575-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "enumeration_date": "2007-02-23",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-865-6175"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "YA0023",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7096951",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "57740",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Avenue Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lincoln Avenue Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.