| |
100 E Jackson Ave, Suite 102, Ellensburg, WA 98926-3692 | |
(509) 453-4614 | |
(509) 225-2712 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 100 E Jackson Ave, Ellensburg, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962938183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | 602902835 (Washington) | Primary |
Mailing Address | Practice Location Address |
---|---|
3800 Summitview Ave, Yakima, WA 98902-2715 Ph: (509) 453-4614 | 100 E Jackson Ave, Suite 102, Ellensburg, WA 98926-3692 Ph: (509) 453-4614 |