YAKIMA VALLEY PROFESSIONAL SERVICES ON 12TH, PC (NPI# 1356393383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356393383 |
| Entity Type | Organization |
| Organization Name | YAKIMA VALLEY PROFESSIONAL SERVICES ON 12TH, PC |
| Other Organization Name | CORNERSTONE MEDICAL CLINIC |
| Practice Address |
402 S 12th Ave Yakima WA 98902-3115 |
| Mailing Address |
Po Box 2947 Yakima WA 98907-2947 |
| Practice Telephone | 5092483263 |
| Practice Fax Number | 5095733818 |
| Mailing Telephone | 5092487849 |
| Mailing Fax Number | 5092495042 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-11-21 |
| Authorized Official Name | MS. CAROLINE GEORGE (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5092487849 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7056922 | 05 |
| Other Name | Type Code |
|---|---|
| Cornerstone Medical Clinic | Doing Business As Name - Organization |
| Street Address |
402 S 12TH AVE |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097210 | Amy D Skiles | Registered Nurse | 402 S 12th Ave, Yakima, WA 98902-3115 | 2020-03-03 |
| 1245720036 | Sarah Jane D Rapanut | Case Manager/Care Coordinator | 402 S 12th Ave, Yakima, WA 98902-3115 | 2018-05-16 |
| 1790203628 | Meghan E Colleran | Nurse Practitioner | 402 S 12th Ave, Yakima, WA 98902-3115 | 2017-08-30 |
| 1063944197 | Anna L Snyder | Pediatrics | 402 S 12th Ave, Yakima, WA 98902-3115 | 2017-03-29 |
| 1962953091 | April K May | Registered Nurse | 402 S 12th Ave, Yakima, WA 98902-3115 | 2016-10-24 |
| 1609240563 | Rishi S Mistry | Nurse Practitioner | 402 S 12th Ave, Yakima, WA 98902-3115 | 2015-11-16 |
| 1124457981 | Michelle L. Linsley | Counselor | 402 S 12th Ave, Yakima, WA 98902-3115 | 2013-11-02 |
| 1902238553 | Irma Sulejmanovic-bordeaux | Nurse Practitioner | 402 S 12th Ave, Yakima, WA 98902-3115 | 2013-08-06 |
| 1194067504 | Peter Gyimah Asante Jr. | Pediatrics | 402 S 12th Ave, Yakima, WA 98902-3115 | 2013-03-24 |
| 1275821472 | Gary Dean Burton Jr. | Pharmacist | 402 S 12th Ave, Yakima, WA 98902-3115 | 2011-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
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| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972745347 | Memorial Practice Management, LLC | Clinic/Center | 1008 S. 38th Ave, Yakima, WA 98902-0000 | 2009-04-01 |
| 1851533228 | Memorial Practice Management, LLC | Clinic/Center | 3003 Tieton Dr Ste 320, Yakima, WA 98902-3688 | 2009-04-01 |
| 1881836252 | Memorial Practice Management, LLC | Clinic/Center | 1111 W Spruce St Ste 30, Yakima, WA 98902-3264 | 2009-04-01 |
| 1154930543 | Yakima Valley Memorial Physicians | Clinic/Center | 1008 S 38th Ave, Yakima, WA 98902-3953 | 2020-07-30 |
| 1699257113 | Memorial Physicians, Pllc | Clinic/Center | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-08-31 |
| 1942695580 | Yakima Medical Consultants Inc | Clinic/Center | 622 S 36th Ave, Yakima, WA 98902-3943 | 2015-03-31 |
| 1588986681 | Memorial Physicians, P.l.l.c. | Clinic/Center | 3909 Creekside Loop, Suite 120, Yakima, WA 98902-4880 | 2010-02-17 |
| 1013239110 | Memorial Physicians, P.l.l.c. | Clinic/Center | 1008 S. 38th Ave, Yakima, WA 98902-0000 | 2010-02-17 |
| 1316269418 | Memorial Physicians, P.l.l.c. | Clinic/Center | 4003 Creekside Loop, Yakima, WA 98908-3959 | 2010-02-17 |
| 1134441231 | Memorial Physicians, P.l.l.c. | Clinic/Center | 504 N 40th Ave, Yakima, WA 98908-4311 | 2010-02-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.