Center For Functional Health Pllc is a medicare enrolled "Clinic/center - Primary Care" provider in Kennewick, Washington. Their current practice location is
1350 N Grant St, Kennewick, Washington. You can reach out to their office (for appointments etc.) via phone at
(509) 735-2014.
Center For Functional Health Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Center For Functional Health Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1295470268.
Healthcare Provider's Profile
| Full Name | Center For Functional Health Pllc |
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| Type | Facility |
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| Speciality | Clinic/center - Primary Care |
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| Location | 1350 N Grant St, Kennewick, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1295470268
- Provider Enumeration Date: 05/03/2022
- Last Update Date: 03/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 7012396674
- Enrollment ID: O20220829003832
Medical Identifiers
Medical identifiers for Center For Functional Health Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295470268 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225700000X | Massage Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Center For Functional Health Pllc acts as a billing entity for following providers:
| Provider Name | Aaron N Johnson |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1760425466
PECOS PAC ID: 9335161991
Enrollment ID: I20051222000554 |
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| Provider Name | Quisto G Oucharek |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1023440237
PECOS PAC ID: 3678700333
Enrollment ID: I20200224002794 |
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| Provider Name | Mitchell J Parks |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1235762782
PECOS PAC ID: 2466838081
Enrollment ID: I20221005003300 |
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| Provider Name | Nichole A Rodriguez |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1063193746
PECOS PAC ID: 3476917386
Enrollment ID: I20230911004176 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Center For Functional Health Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Center For Functional Health Pllc
1350 N Grant St,
Kennewick, WA 99336-1355
Ph: (509) 735-2014 | Center For Functional Health Pllc
1350 N Grant St,
Kennewick, WA 99336-1355
Ph: (509) 735-2014 |
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