| Restoration Medical Care | |
|
406 Se 131st Ave Suite 109 Vancouver WA 98683-4004 | |
| (541) 991-1006 | |
| (360) 326-2271 |
| Full Name | Restoration Medical Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 406 Se 131st Ave, Vancouver, Washington |
| Authorized Official Name and Position | Jason Hill Works (ADMINISTRATOR) |
| Authorized Official Contact | 5419911006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Medical Care 406 Se 131st Ave Ste 109 Vancouver WA 98683-4031 Ph: (541) 991-1006 | Restoration Medical Care 406 Se 131st Ave Suite 109 Vancouver WA 98683-4004 Ph: (541) 991-1006 |
| NPI Number | 1629454327 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 04/11/2017 |
| Medicare PECOS PAC ID | 0143538264 |
|---|---|
| Medicare Enrollment ID | O20151008002469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629454327 | NPI | - | NPPES |
| 500634349 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OP60159597 (Washington) | Primary |
| Provider Name | Stephanie L Works |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639351729 PECOS PAC ID: 2466577903 Enrollment ID: I20100921000426 |
| Provider Name | Robert J Klein |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1770679987 PECOS PAC ID: 7113082488 Enrollment ID: I20210401002033 |
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