Park Place Medical Center | |
13115 Ne 4th St Suite 230 Vancouver WA 98684-5957 | |
(360) 828-8008 | |
(360) 326-1609 |
Full Name | Park Place Medical Center |
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Speciality | Clinic/Center |
Location | 13115 Ne 4th St, Vancouver, Washington |
Authorized Official Name and Position | Peter James Bessas (OWNER) |
Authorized Official Contact | 3608288008 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Park Place Medical Center 13115 Ne 4th St Suite 230 Vancouver WA 98684-5957 Ph: (360) 828-8008 | Park Place Medical Center 13115 Ne 4th St Suite 230 Vancouver WA 98684-5957 Ph: (360) 828-8008 |
NPI Number | 1780751818 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 08/18/2015 |
Medicare PECOS PAC ID | 0840290029 |
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Medicare Enrollment ID | O20070111000628 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780751818 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | MD00041827 (Washington) | Primary |
Provider Name | Peter J Bessas |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992756498 PECOS PAC ID: 9032119219 Enrollment ID: I20070111000620 |
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