| |
335 Una Ave Cathlamet WA 98612-9583 | |
(360) 465-2990 | |
(360) 414-1114 |
Full Name | |
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Speciality | Clinic/Center |
Location | 335 Una Ave, Cathlamet, Washington |
Authorized Official Name and Position | James Coffee (CEO) |
Authorized Official Contact | 3606363892 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1057 12th Ave Longview WA 98632-2509 Ph: (360) 636-3892 | 335 Una Ave Cathlamet WA 98612-9583 Ph: (360) 465-2990 |
NPI Number | 1538497417 |
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Provider Enumeration Date | 12/03/2009 |
Last Update Date | 05/24/2024 |
Medicare PECOS PAC ID | 5991696395 |
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Medicare Enrollment ID | O20100309000580 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538497417 | NPI | - | NPPES |
50-1922 | Other | WA | MEDICARE PTAN |
7407349 | Medicaid | WA | |
7900426 | Medicaid | WA | |
7086523 | Medicaid | WA |