| Columbia Sands Medical Specialities, Llc | |
|
1245 Nw 4th St Ste 201 Redmond OR 97756-1680 | |
| (541) 526-6626 | |
| Not Available |
| Full Name | Columbia Sands Medical Specialities, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1245 Nw 4th St Ste 201, Redmond, Oregon |
| Authorized Official Name and Position | Richard W Fawcett (OWNER) |
| Authorized Official Contact | 5414080436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Sands Medical Specialities, Llc 1245 Nw 4th St Ste 201 Redmond OR 97756-1680 Ph: (541) 526-6626 | Columbia Sands Medical Specialities, Llc 1245 Nw 4th St Ste 201 Redmond OR 97756-1680 Ph: (541) 526-6626 |
| NPI Number | 1679705289 |
|---|---|
| Provider Enumeration Date | 08/14/2009 |
| Last Update Date | 10/01/2009 |
| Medicare PECOS PAC ID | 0547306383 |
|---|---|
| Medicare Enrollment ID | O20091007000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679705289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Richard W Fawcett |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124056494 PECOS PAC ID: 2961431770 Enrollment ID: I20050811000366 |
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