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1813 Sumner Ave Aberdeen WA 98520-4600 | |
| (360) 538-1293 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1813 Sumner Ave, Aberdeen, Washington |
| Authorized Official Name and Position | Mary Bartolo (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 2067883224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 1813 Sumner Ave Aberdeen WA 98520-4600 Ph: (360) 538-1293 |
| NPI Number | 1306982608 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306982608 | NPI | - | NPPES |
| 2000114 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6005372781 (Washington) | Primary |
Todd S. Johnson, Dds, Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 W Market St, Aberdeen, WA 98520 Phone: 360-533-7120 Fax: 360-532-1250 | |
Harbor Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 E 1st St, Aberdeen, WA 98520 Phone: 360-533-0882 Fax: 360-533-1314 | |
George M. Whitehead D.d.s., Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 East First Street, Suite B, Aberdeen, WA 98520 Phone: 360-533-2726 Fax: 360-532-9915 | |
Adam P Cramer Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 W 4th St, Aberdeen, WA 98520 Phone: 360-532-7512 |