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 |
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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 |
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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 |
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Provider Enumeration Date | 10/18/2010 |
Last Update Date | 10/18/2010 |
Medicare PECOS PAC ID | 4587858741 |
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Medicare Enrollment ID | O20101101001455 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518277011 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Rick L Jackson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306983549 PECOS PAC ID: 5496949653 Enrollment ID: I20101101001473 |
Provider Name | Dennis E Morrisroe |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659553741 PECOS PAC ID: 4981884277 Enrollment ID: I20110203000249 |
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