Full Name | |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 118 S 2nd St, Selah, Washington |
Authorized Official Name and Position | Caroline George (DIRECTOR OF FINANCE) |
Authorized Official Contact | 5092487849 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2947 Yakima WA 98907-2947 Ph: (509) 248-7849 | 118 S 2nd St Selah WA 98942-1308 Ph: (509) 697-4827 |
NPI Number | 1902078736 |
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Provider Enumeration Date | 04/01/2008 |
Last Update Date | 06/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902078736 | NPI | - | NPPES |
7056898 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Frederick J Thysell Md Inc Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1416 Jesica Dr, Selah, WA 98942 Phone: 509-823-3861 Fax: 509-697-3819 | |