| Castle Rock Pediatrics And Family Wellness Center | |
|
139 First Avenue Sw Castle Rock WA 98611-0160 | |
| (360) 274-2353 | |
| (360) 274-2354 |
| Full Name | Castle Rock Pediatrics And Family Wellness Center |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 139 First Avenue Sw, Castle Rock, Washington |
| Authorized Official Name and Position | Reinhild Ayoub (OWNER/PRACTITIONER) |
| Authorized Official Contact | 3602742353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Castle Rock Pediatrics And Family Wellness Center Po Box 160 Castle Rock WA 98611-0160 Ph: (360) 274-2353 | Castle Rock Pediatrics And Family Wellness Center 139 First Avenue Sw Castle Rock WA 98611-0160 Ph: (360) 274-2353 |
| NPI Number | 1770767477 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 11/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770767477 | NPI | - | NPPES |
| 7094261 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 601 929 001 11 (Washington) | Primary |
Emma V Torres Baltazar Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 606 Se Roake Avenue, Castle Rock, WA 98611 Phone: 360-274-4179 | |
Generoso Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23 Cowlitz W, Castle Rock, WA 98611 Phone: 872-395-1626 |