| Northwest Family & Spinal Clinic Inc Ps | |
|
1802 S Union Ave Suite 200 Tacoma WA 98405 | |
| (253) 752-6965 | |
| (253) 759-6056 |
| Full Name | Northwest Family & Spinal Clinic Inc Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 1802 S Union Ave, Tacoma, Washington |
| Authorized Official Name and Position | Kenneth Cj Scherbarth (CORPORATE PRESIDENT) |
| Authorized Official Contact | 2537526965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Family & Spinal Clinic Inc Ps 1802 S Union Ave Tacoma WA 98405-1947 Ph: (253) 752-6965 | Northwest Family & Spinal Clinic Inc Ps 1802 S Union Ave Suite 200 Tacoma WA 98405 Ph: (253) 752-6965 |
| NPI Number | 1548357098 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 05/14/2015 |
| Medicare PECOS PAC ID | 8527956226 |
|---|---|
| Medicare Enrollment ID | O20040305000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548357098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kenneth J Kirkwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235221813 PECOS PAC ID: 2264480425 Enrollment ID: I20050105000365 |
| Provider Name | Kenneth C Scherbarth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942297353 PECOS PAC ID: 9234027939 Enrollment ID: I20100422000228 |
| Provider Name | Mariah Lache Mosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144880188 PECOS PAC ID: 4082941182 Enrollment ID: I20210127000466 |
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