| Littlerock Family Medicine, P.s. | |
|
6981 Littlerock Rd Sw Ste 101 Tumwater WA 98512-7226 | |
| (360) 943-3633 | |
| (360) 528-4643 |
| Full Name | Littlerock Family Medicine, P.s. |
|---|---|
| Speciality | Family Medicine |
| Location | 6981 Littlerock Rd Sw Ste 101, Tumwater, Washington |
| Authorized Official Name and Position | William K Harris (PRESIDENT) |
| Authorized Official Contact | 3609433633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Littlerock Family Medicine, P.s. 6981 Littlerock Rd Sw Tumwater WA 98512-7226 Ph: (360) 943-3633 | Littlerock Family Medicine, P.s. 6981 Littlerock Rd Sw Ste 101 Tumwater WA 98512-7226 Ph: (360) 943-3633 |
| NPI Number | 1689994527 |
|---|---|
| Provider Enumeration Date | 06/02/2010 |
| Last Update Date | 03/25/2013 |
| Medicare PECOS PAC ID | 0042453748 |
|---|---|
| Medicare Enrollment ID | O20130828000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689994527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 602927476 (Washington) | Primary |
| Provider Name | William Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588662068 PECOS PAC ID: 1951293679 Enrollment ID: I20040827000286 |
| Provider Name | Shana L Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437179546 PECOS PAC ID: 8820020514 Enrollment ID: I20050901000755 |
| Provider Name | Anita J Markham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871861658 PECOS PAC ID: 7517126402 Enrollment ID: I20120313000479 |
| Provider Name | Petrina E Gavrilis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700958493 PECOS PAC ID: 1052534690 Enrollment ID: I20140617002168 |
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