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1812 N 13th Loop Rd Shelton WA 98584-2169 | |
(360) 426-3862 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1812 N 13th Loop Rd, Shelton, Washington |
Authorized Official Name and Position | Eric Moll (CEO) |
Authorized Official Contact | 3604279556 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1812 N 13th Loop Rd Shelton WA 98584-2169 Ph: (360) 426-3862 | 1812 N 13th Loop Rd Shelton WA 98584-2169 Ph: (360) 426-3862 |
NPI Number | 1164876629 |
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Provider Enumeration Date | 04/20/2016 |
Last Update Date | 04/14/2017 |
Medicare PECOS PAC ID | 6608932116 |
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Medicare Enrollment ID | O20160706001095 |
Identifier | Type | State | Issuer |
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1164876629 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Olympic Physicians, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Professional Way, Shelton, WA 98584 Phone: 360-426-2500 Fax: 360-462-2500 | |
Northwest Indian Treatment Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Se Whitener Rd, Shelton, WA 98584 Phone: 360-470-1474 |