| |
611 S Chestnut St Ste C, Ellensburg, WA 98926-4815 | |
(509) 925-4633 | |
(509) 225-5448 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 611 S Chestnut St Ste C, Ellensburg, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992513840 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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Po Box 825159, Department S, Philadelphia, PA 19182-0001 Ph: (509) 925-4633 | 611 S Chestnut St Ste C, Ellensburg, WA 98926-4815 Ph: (509) 925-4633 |