Evillagehealth | |
3419 E Elena Ln Chattaroy WA 99003-5121 | |
(509) 960-6527 | |
(833) 989-2072 |
Full Name | Evillagehealth |
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Speciality | Clinic/Center |
Location | 3419 E Elena Ln, Chattaroy, Washington |
Authorized Official Name and Position | Jessica A. Blackwell (OWNER AND PROVIDER) |
Authorized Official Contact | 5099606527 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Evillagehealth 3419 E Elena Ln Chattaroy WA 99003-5121 Ph: (509) 960-6527 | Evillagehealth 3419 E Elena Ln Chattaroy WA 99003-5121 Ph: (509) 960-6527 |
NPI Number | 1669087367 |
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Provider Enumeration Date | 09/10/2020 |
Last Update Date | 06/06/2022 |
Medicare PECOS PAC ID | 0941610711 |
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Medicare Enrollment ID | O20201105002178 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669087367 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Jessica A Blackwell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902859895 PECOS PAC ID: 2860424322 Enrollment ID: I20050906000419 |
Nathan P Stime Md Riverside Medical-dental Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 34705 N Newport Hwy, Suite A, Chattaroy, WA 99003 Phone: 509-292-2700 Fax: 509-292-9744 |