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1787 Ne Kresky Ave Chehalis WA 98532-2302 | |
(360) 748-4339 | |
(360) 748-3349 |
Full Name | |
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Speciality | Clinic/center |
Location | 1787 Ne Kresky Ave, Chehalis, Washington |
Authorized Official Name and Position | Malinda G Greenwood (ADMINISTRATIVE MANAGER) |
Authorized Official Contact | 3607484393 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1787 Ne Kresky Ave Chehalis WA 98532-2302 Ph: (360) 748-4339 | 1787 Ne Kresky Ave Chehalis WA 98532-2302 Ph: (360) 748-4339 |
NPI Number | 1649544693 |
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Provider Enumeration Date | 03/07/2012 |
Last Update Date | 03/07/2012 |
Identifier | Type | State | Issuer |
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1649544693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 21155800 (Washington) | Primary |
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