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3010 State Route 109 Copalis Beach WA 98535 | |
(360) 289-2472 | |
(360) 283-9982 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 3010 State Route 109, Copalis Beach, Washington |
Authorized Official Name and Position | Rogelio Riojas (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2067635277 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34703 Seattle WA 98124-1703 Ph: (206) 764-3335 | 3010 State Route 109 Copalis Beach WA 98535 Ph: (360) 289-2472 |
NPI Number | 1811182223 |
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Provider Enumeration Date | 09/10/2007 |
Last Update Date | 03/12/2010 |
Identifier | Type | State | Issuer |
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1811182223 | NPI | - | NPPES |