| Rainier Family And Sports Medicine P C | |
|
16202 64th St E Ste 104 Sumner WA 98390-3028 | |
| (253) 987-7754 | |
| (253) 987-7049 |
| Full Name | Rainier Family And Sports Medicine P C |
|---|---|
| Speciality | Family Medicine |
| Location | 16202 64th St E Ste 104, Sumner, Washington |
| Authorized Official Name and Position | Kent R Walker (CEO/PRESIDENT) |
| Authorized Official Contact | 2539877754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainier Family And Sports Medicine P C 1402 Lake Tapps Pkwy Se Ste F104 #133 Sumner WA 98390 Ph: (253) 987-7754 | Rainier Family And Sports Medicine P C 16202 64th St E Ste 104 Sumner WA 98390-3028 Ph: (253) 987-7754 |
| NPI Number | 1588280804 |
|---|---|
| Provider Enumeration Date | 06/23/2020 |
| Last Update Date | 09/14/2020 |
| Medicare PECOS PAC ID | 3870912389 |
|---|---|
| Medicare Enrollment ID | O20201002000958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588280804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Kent R Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902820020 PECOS PAC ID: 9537283692 Enrollment ID: I20111005000467 |
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