| Ashbrook Medical Family Practice Ps | |
|
5512 Ne 107th Ave Vancouver WA 98662-6169 | |
| (360) 892-2030 | |
| (360) 892-1999 |
| Full Name | Ashbrook Medical Family Practice Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 5512 Ne 107th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Nathan P Wilson (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3608922030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashbrook Medical Family Practice Ps 5512 Ne 107th Ave Vancouver WA 98662-6169 Ph: (360) 892-2030 | Ashbrook Medical Family Practice Ps 5512 Ne 107th Ave Vancouver WA 98662-6169 Ph: (360) 892-2030 |
| NPI Number | 1518277011 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 10/18/2010 |
| Medicare PECOS PAC ID | 4587858741 |
|---|---|
| Medicare Enrollment ID | O20101101001455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518277011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rick L Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306983549 PECOS PAC ID: 5496949653 Enrollment ID: I20101101001473 |
| Provider Name | Dennis E Morrisroe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659553741 PECOS PAC ID: 4981884277 Enrollment ID: I20110203000249 |
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