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840 S Meyers St Kettle Falls WA 99141-7005 | |
(509) 685-7848 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 840 S Meyers St, Kettle Falls, Washington |
Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC ENROLLMNT/DIR REIMB REG) |
Authorized Official Contact | 4255255392 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 421 Liberty Lake WA 99019-0421 Ph: (509) 685-7848 | 840 S Meyers St Kettle Falls WA 99141-7005 Ph: (509) 685-7848 |
NPI Number | 1538413109 |
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Provider Enumeration Date | 11/05/2012 |
Last Update Date | 10/15/2019 |
Medicare PECOS PAC ID | 0345139929 |
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Medicare Enrollment ID | O20130510000564 |
Identifier | Type | State | Issuer |
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1538413109 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |