Yakima River Pain Management Ps

NPI #1043559081 in Ellensburg, Washington

Provider Information

NPI Number: 1043559081
Entity Type: Organization
Organization Name: Yakima River Pain Management Ps
Primary Specialty: Clinic/Center - Pain
Enumeration Date: Feb 12, 2013
Last Updated: Mar 15, 2013

Practice Location

Address: 109 S WATER ST
Address 2: SUITE 2
City: Ellensburg
State: Washington
ZIP Code: 98926-3061
Phone: (509) 962-2273

Authorized Official

Name: MR. GARY L FAVERO
Title: OWNER/PRESIDENT
Phone: (509) 962-2273

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Clinic/Center - Pain — Pain	261QP3300X	Primary

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