| Isumataq Corporation | |
|
750 George Washington Way Suite 5 Richland WA 99352-4247 | |
| (509) 947-6270 | |
| (509) 946-2011 |
| Full Name | Isumataq Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 750 George Washington Way, Richland, Washington |
| Authorized Official Name and Position | Robert Louis Drury (PRESIDENT) |
| Authorized Official Contact | 5099476270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Isumataq Corporation 750 George Washington Way Suite 5 Richland WA 99352-4247 Ph: (509) 947-6270 | Isumataq Corporation 750 George Washington Way Suite 5 Richland WA 99352-4247 Ph: (509) 947-6270 |
| NPI Number | 1114094471 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114094471 | NPI | - | NPPES |
| PY 1911 | Other | WA | PSYCHOLOGY LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 1911 (Washington) | Primary |
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