| Orchards Family Medicine, Inc. Ps | |
|
9300 Ne Vancouver Mall Dr Ste 201 Vancouver WA 98662-8206 | |
| (360) 567-0488 | |
| (360) 567-0489 |
| Full Name | Orchards Family Medicine, Inc. Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 9300 Ne Vancouver Mall Dr Ste 201, Vancouver, Washington |
| Authorized Official Name and Position | Elise Leaf Leland (PRESIDENT) |
| Authorized Official Contact | 3605670488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchards Family Medicine, Inc. Ps 9300 Ne Vancouver Mall Dr Ste 201 Vancouver WA 98662-8206 Ph: (360) 567-0488 | Orchards Family Medicine, Inc. Ps 9300 Ne Vancouver Mall Dr Ste 201 Vancouver WA 98662-8206 Ph: (360) 567-0488 |
| NPI Number | 1417036849 |
|---|---|
| Provider Enumeration Date | 11/05/2006 |
| Last Update Date | 10/19/2015 |
| Medicare PECOS PAC ID | 3971530973 |
|---|---|
| Medicare Enrollment ID | O20050721000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417036849 | NPI | - | NPPES |
| 838530000 | Other | OR | REGENCE BLUE CROSS GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY60285535 (Washington) | Secondary |
| 207Q00000X | Family Medicine | MD00044580 (Washington) | Primary |
| 213E00000X | Podiatrist | P0515 (Washington) | Secondary |
| Provider Name | Elise L Leland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336228766 PECOS PAC ID: 9133156136 Enrollment ID: I20050803000396 |
| Provider Name | Kenneth J Meigs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881783090 PECOS PAC ID: 0941497697 Enrollment ID: I20161222001499 |
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