| New Health Northport Medical | |
|
411 Summit Northport WA 99157-0178 | |
| (509) 732-4252 | |
| (509) 732-4318 |
| Full Name | New Health Northport Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 411 Summit, Northport, Washington |
| Authorized Official Name and Position | Donna Poe (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5099356001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Health Northport Medical Po Box 808 Chewelah WA 99109-0808 Ph: (509) 935-6001 | New Health Northport Medical 411 Summit Northport WA 99157-0178 Ph: (509) 732-4252 |
| NPI Number | 1316994247 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 07/18/2023 |
| Medicare PECOS PAC ID | 1951202373 |
|---|---|
| Medicare Enrollment ID | O20120320000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316994247 | NPI | - | NPPES |
| 80300 | Other | WA | LABOR & INDUSTRIES ID |
| 7034457 | Medicaid | WA | |
| 7034150 | Medicaid | WA | |
| 703440 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | J600317870 (Washington) | Primary |