Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 103 Washburn, Lopez, Washington |
Authorized Official Name and Position | Elise J Cutter (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 3602991301 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1211 24th St Anacortes WA 98221-2557 Ph: (360) 299-1300 | 103 Washburn Lopez WA 98261 Ph: (360) 468-2245 |
NPI Number | 1609896802 |
---|---|
Provider Enumeration Date | 07/20/2006 |
Last Update Date | 01/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609896802 | NPI | - | NPPES |
7105398 | Medicaid | WA | |
0034447 | Other | WA | LABOR & INDUSTRIES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | H134 (Washington) | Primary |