YAKIMA VALLEY DERMATOLOGY INC PS (NPI# 1710173703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710173703 |
| Entity Type | Organization |
| Organization Name | YAKIMA VALLEY DERMATOLOGY INC PS |
| Other Organization Name | VALLEY DERMATOLOGY ASSOCIATES |
| Practice Address |
506 N 40th Ave # 201 Yakima WA 98908 |
| Practice Telephone | 5099667899 |
| Practice Fax Number | 5092256811 |
| Mailing Telephone | 5099667899 |
| Mailing Fax Number | 5092256811 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2011-06-30 |
| Authorized Official Name | CAROLE EL VIOLETTE (CLINIC MGR) |
| Authorized Official Telephone | 5099651714 |
| Authorized Official Credential | BSB/ACC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004546 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8178956 | 05 |
| Other Name | Type Code |
|---|---|
| Valley Dermatology Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831387489 | Yakima Valley Dermatology Inc Ps | Dermatology | 3911 Castlevale Rd Ste 301, Yakima, WA 98902-7807 | 2007-10-09 |
| Street Address |
506 N 40TH AVE # 201 |
| City | YAKIMA |
| State | WA |
| Zip Code | 98908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857941 | Hillary Leigh Frank | Massage Therapist | 607 S 48th Ave Suite A, Yakima, WA 98908 | 2020-10-07 |
| 1255976056 | Olusegun Adesesan Bamgbelu | Pharmacist | Memorial Cornerstone Pharmacy, 4003 Creekside Loop, Yakima, WA 98908 | 2019-11-15 |
| 1699325811 | Sunrise Dental of Yakima | Dentist | 1020 South 40th Avenue, Suite G, Yakima, WA 98908 | 2019-09-19 |
| 1558896175 | Alyssa Noelle Wickenhagen | Specialist/Technologist | 106 N 91st Ave, Yakima, WA 98908 | 2017-04-21 |
| 1962861591 | Vanessa Roth | Massage Therapist | 10607 Wide Hollow Road, Yakima, WA 98908 | 2016-02-10 |
| 1407214000 | Kristine Mcclure | Counselor | 506 N 40th Ave Ste 201, Yakima, WA 98908 | 2016-02-10 |
| 1245635069 | Harry Williams | Pharmacist | 6600 West Nob Hill Blvd, Yakima, WA 98908 | 2014-10-23 |
| 1508107509 | Richard Paul Bustetter | Registered Nurse | 6513 West Chestnut Ave, Elite Nursing P.l.l.c., Yakima, WA 98908 | 2013-03-15 |
| 1528305331 | Beverly Irene Chandler | Licensed Practical Nurse | 6573 W. Chestnut Ave, Yakima, WA 98908 | 2013-01-14 |
| 1225373764 | Susan Schell | Licensed Practical Nurse | 6513 W.chestnut Ave, Elite Nursing, Yakima, WA 98908 | 2012-12-11 |
| Find all providers in zip 98908 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1538196654 | Gretchen A Kaizer | Physician Assistant | 406 S. 30th Ave, Suite 101, Yakima, WA 98902 | 2006-06-26 |
| 1619444742 | Josephine Virgen | Physician Assistant | 3300 Roosevelt Ave, Yakima, WA 98902-6344 | 2018-10-26 |
| 1649726852 | Salvador Lopez | Physician Assistant | 310 Holton Ave, Yakima, WA 98902-3208 | 2016-08-28 |
| 1649625963 | Zachary Ronald Grunig | Physician Assistant | 1110 N 35th Ave, Yakima, WA 98902-1622 | 2016-04-25 |
| 1164762621 | Daniel Mark Richmond | Physician Assistant | 602 E Nob Hill Blvd, Yakima, WA 98901-3534 | 2013-02-20 |
| 1538463252 | Wade Allen Holden | Physician Assistant | 3909 Creekside Loop Ste 115, Yakima, WA 98902-4880 | 2011-01-10 |
| 1396998001 | Coleen Foreman | Physician Assistant | 3003 Tieton Dr, Suite 200, Yakima, WA 98902-3679 | 2008-10-24 |
| 1124217583 | Bridget Bernice Albright | Physician Assistant | 602 E Nob Hill Blvd, Yakima, WA 98901-3534 | 2007-10-22 |
| 1003007279 | Jennifer Christi Williams | Physician Assistant | 602 E Nob Hill Blvd, Yakima, WA 98901-3534 | 2007-08-05 |
| Find all providers in YAKIMA | ||||
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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.