| |
1515 E Columbia St, Othello, WA 99344-1846 | |
(509) 488-5256 | |
(509) 488-9939 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1515 E Columbia St, Othello, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992923064 | NPI | - | NPPES |
8908941 | Other | WA | CRIME VICTIMS # |
2029130 | Medicaid | WA | |
0035900 | Other | WA | DEPT L&I # |
7107675 | Other | WA | UGS MDC DSHS CROSSOVER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Washington) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | OD00003794 (Washington) | Primary |
Mailing Address | Practice Location Address |
---|---|
1515 E. Columbia St., Othello, WA 99344 Ph: (509) 488-5256 | 1515 E Columbia St, Othello, WA 99344-1846 Ph: (509) 488-5256 |