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N. 115 Crosby St. Tekoa WA 99033-0629 | |
(509) 284-2423 | |
(509) 284-3434 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | N. 115 Crosby St., Tekoa, Washington |
Authorized Official Name and Position | Peter J Martin (ADMINISTRATOR) |
Authorized Official Contact | 5092842423 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 629 Tekoa WA 99033-0629 Ph: (509) 284-2423 | N. 115 Crosby St. Tekoa WA 99033-0629 Ph: (509) 284-2423 |
NPI Number | 1366768046 |
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Provider Enumeration Date | 04/20/2010 |
Last Update Date | 04/20/2010 |
Identifier | Type | State | Issuer |
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1366768046 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |