| Cascade Family Medical Clinic Inc Ps | |
|
1740 Cooks Hill Rd Centralia WA 98531-9071 | |
| (360) 736-7623 | |
| (360) 736-4074 |
| Full Name | Cascade Family Medical Clinic Inc Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 1740 Cooks Hill Rd, Centralia, Washington |
| Authorized Official Name and Position | Christopher L Yarter (PRESIDENT) |
| Authorized Official Contact | 3607367623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Family Medical Clinic Inc Ps 1740 Cooks Hill Rd Centralia WA 98531-9071 Ph: (360) 736-7623 | Cascade Family Medical Clinic Inc Ps 1740 Cooks Hill Rd Centralia WA 98531-9071 Ph: (360) 736-7623 |
| NPI Number | 1376536136 |
|---|---|
| Provider Enumeration Date | 08/26/2005 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376536136 | NPI | - | NPPES |
| 7089634 | Medicaid | WA | |
| 0031980 | Other | WA | L & I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 600344469 (Washington) | Primary |
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