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DSH500036AF YAKIMA VALLEY MEMORIAL HOSPITAL (Approved)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
PET Scan (Valley Imaging PET Scan) - PET Scan
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500036AF
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/15/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/5/2025
Last Recertification Date
Contacts
Authorizing Official
Yakima Valley Memorial Hospital
Tammy K. Buyok, President and Market Leader
(509) 575-8001
Primary Contact
Yakima Valley Memorial Hospital
Jake Aaron Bradshaw, Director of Pharmacy
(509) 746-2002
Addresses
Street Address
314 S 11th Ave
Suite B
Yakima, WA 98902-3212
Billing Address
MultiCare Yakima Memorial Hospital
PO Box 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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