Mid-valley Community Clinic, Pllc | |
700 S 11th St Sunnyside WA 98944-2243 | |
(509) 839-6822 | |
(509) 839-5913 |
Full Name | Mid-valley Community Clinic, Pllc |
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Speciality | Family Medicine |
Location | 700 S 11th St, Sunnyside, Washington |
Authorized Official Name and Position | Harlan D. Halma (MEDICAL DIRECTOR) |
Authorized Official Contact | 5098396822 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mid-valley Community Clinic, Pllc Po Box 957 Sunnyside WA 98944-0957 Ph: (509) 839-6822 | Mid-valley Community Clinic, Pllc 700 S 11th St Sunnyside WA 98944-2243 Ph: (509) 839-6822 |
NPI Number | 1447203104 |
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Provider Enumeration Date | 05/17/2006 |
Last Update Date | 04/25/2011 |
Medicare PECOS PAC ID | 8729976998 |
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Medicare Enrollment ID | O20040309000567 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447203104 | NPI | - | NPPES |
8283707 | Medicaid | WA | |
MD00026187 | Other | WA | DR WRUNG STATE LICENSE |
MD00032042 | Other | WA | DR HALMA STATE LICENSE |
1052273 | Medicaid | WA | |
OP00000839 | Other | WA | DR. SWOFFORD STATE LICENS |
8156861 | Medicaid | WA | |
7075070 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 601689666 (Washington) | Primary |
Provider Name | David W Shoemaker |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1912932658 PECOS PAC ID: 2365339736 Enrollment ID: I20040301000894 |
Provider Name | Douglas E Wrung |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689751679 PECOS PAC ID: 8022000777 Enrollment ID: I20040831001271 |
Provider Name | Harlan D Halma |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487609814 PECOS PAC ID: 3072505726 Enrollment ID: I20041102000582 |
Provider Name | Robert E Coleman |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1174671192 PECOS PAC ID: 0840182010 Enrollment ID: I20070717000751 |
Provider Name | David J Swofford |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427125848 PECOS PAC ID: 6800811563 Enrollment ID: I20120104000856 |
Provider Name | Irma Z Mejia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366880734 PECOS PAC ID: 4880835800 Enrollment ID: I20130802000020 |
Provider Name | Blake Bond |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053605493 PECOS PAC ID: 0345480091 Enrollment ID: I20140712000098 |
Provider Name | Kristin L Bond |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770877110 PECOS PAC ID: 6103067301 Enrollment ID: I20141015002464 |
Provider Name | Elba Fernandez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780132704 PECOS PAC ID: 4385924927 Enrollment ID: I20161216001601 |
Provider Name | Mariana Guerrero-sanchez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851013973 PECOS PAC ID: 8123494408 Enrollment ID: I20221012002244 |
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