| |
1003 Wallace Way Grandview WA 98930 | |
(509) 786-1576 | |
(509) 786-6612 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1003 Wallace Way, Grandview, Washington |
Authorized Official Name and Position | Craig Marks (CEO) |
Authorized Official Contact | 5097862222 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
723 Memorial St Prosser WA 99350-1524 Ph: (509) 786-6681 | 1003 Wallace Way Grandview WA 98930 Ph: (509) 786-1576 |
NPI Number | 1376026237 |
---|---|
Provider Enumeration Date | 09/07/2018 |
Last Update Date | 03/31/2020 |
Medicare PECOS PAC ID | 6709787872 |
---|---|
Medicare Enrollment ID | O20190222000964 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376026237 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Northwest Reliance Solutions Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Euclid St, Grandview, WA 98930 Phone: 509-882-1331 Fax: 509-882-2850 | |
Yvwfc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 Division St, Grandview, WA 98930 Phone: 509-840-9872 |