| Providence Medical Group Chehalis Family Medicine | |
|
931 S Market Blvd Chehalis WA 98532-3423 | |
| (360) 767-6300 | |
| (360) 767-6320 |
| Full Name | Providence Medical Group Chehalis Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 931 S Market Blvd, Chehalis, Washington |
| Authorized Official Name and Position | Daniel T Harris (CFO) |
| Authorized Official Contact | 4256873603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Chehalis Family Medicine Po Box 34439 Seattle WA 98124-1439 Ph: (425) 525-6650 | Providence Medical Group Chehalis Family Medicine 931 S Market Blvd Chehalis WA 98532-3423 Ph: (360) 767-6300 |
| NPI Number | 1518264357 |
|---|---|
| Provider Enumeration Date | 02/14/2011 |
| Last Update Date | 04/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518264357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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