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10 Pacific Lane South Pacific Beach WA 98571 | |
(360) 580-0748 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 10 Pacific Lane South, Pacific Beach, Washington |
Authorized Official Name and Position | Dorothy Chaffee Flaherty (OWNER) |
Authorized Official Contact | 3605800748 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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10 Pacific Lane South P.o. Box 191 Pacific Beach WA 98571 Ph: (360) 580-0748 | 10 Pacific Lane South Pacific Beach WA 98571 Ph: (360) 580-0748 |
NPI Number | 1023246667 |
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Provider Enumeration Date | 06/22/2009 |
Last Update Date | 06/22/2009 |
Identifier | Type | State | Issuer |
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1023246667 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | LW60004868 (Washington) | Primary |