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North 115 Crosby Street Tekoa WA 99033-0629 | |
| (509) 284-2423 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | North 115 Crosby Street, Tekoa, Washington |
| Authorized Official Name and Position | Robin Ann Harp (OFFICE MANAGER) |
| Authorized Official Contact | 5092842423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 629 N 115 Crosby Tekoa WA 99033-0629 Ph: (509) 284-2423 | North 115 Crosby Street Tekoa WA 99033-0629 Ph: (509) 284-2423 |
| NPI Number | 1285766469 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285766469 | NPI | - | NPPES |
| 7069875 | Medicaid | WA | |
| 7075971 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 601652856 (Washington) | Primary |