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309 Knappton Rd Naselle WA 98638-8632 | |
(360) 484-7161 | |
(360) 484-7181 |
Full Name | |
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Speciality | Clinic/Center |
Location | 309 Knappton Rd, Naselle, Washington |
Authorized Official Name and Position | Larry Cohen (CEO) |
Authorized Official Contact | 3606423181 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 188 21 North Valley Road Naselle WA 98638-0188 Ph: (360) 484-7161 | 309 Knappton Rd Naselle WA 98638-8632 Ph: (360) 484-7161 |
NPI Number | 1881858140 |
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Provider Enumeration Date | 07/16/2008 |
Last Update Date | 11/17/2021 |
Medicare PECOS PAC ID | 7214822105 |
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Medicare Enrollment ID | O20041119000815 |
Identifier | Type | State | Issuer |
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1881858140 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | HAC.FS.00000079 (Washington) | Primary |