| Great West Family Care Pc | |
|
14508 Ne 20th Ave Suite 102 Vancouver WA 98686-6434 | |
| (360) 574-9730 | |
| (360) 576-7662 |
| Full Name | Great West Family Care Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 14508 Ne 20th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Rebecca L Hoffman (PRESIDENT) |
| Authorized Official Contact | 3605749730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great West Family Care Pc 14508 Ne 20th Ave Suite 102 Vancouver WA 98686-6434 Ph: (360) 574-9730 | Great West Family Care Pc 14508 Ne 20th Ave Suite 102 Vancouver WA 98686-6434 Ph: (360) 574-9730 |
| NPI Number | 1427073840 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 12/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427073840 | NPI | - | NPPES |
| 7124530 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 602202713 (Washington) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 602202713 (Washington) | Primary |
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