Provider Demographics
NPI:1316962186
Name:YAKIMA HMA HOME HEALTH, LLC
Entity type:Organization
Organization Name:YAKIMA HMA HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATHIESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-837-1379
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0719
Mailing Address - Country:US
Mailing Address - Phone:509-575-5093
Mailing Address - Fax:
Practice Address - Street 1:7 S 10TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3318
Practice Address - Country:US
Practice Address - Phone:509-575-5093
Practice Address - Fax:509-454-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602279686WA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3990108Medicaid
501518Medicare Oscar/Certification