| Trinity Medical Pc | |
|
1025 S 2nd Ave Walla Walla WA 99362-4116 | |
| (702) 453-3799 | |
| (702) 453-5741 |
| Full Name | Trinity Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1025 S 2nd Ave, Walla Walla, Washington |
| Authorized Official Name and Position | Christopher J Ryan (SOLE OWNER) |
| Authorized Official Contact | 8053259385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Medical Pc Po Box 1230 Monument CO 80132-1230 Ph: (702) 453-3799 | Trinity Medical Pc 1025 S 2nd Ave Walla Walla WA 99362-4116 Ph: (702) 453-3799 |
| NPI Number | 1760921423 |
|---|---|
| Provider Enumeration Date | 02/14/2017 |
| Last Update Date | 02/14/2017 |
| Medicare PECOS PAC ID | 4981988094 |
|---|---|
| Medicare Enrollment ID | O20170728000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760921423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60324829 (Washington) | Primary |
| Provider Name | Christopher J Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790881357 PECOS PAC ID: 3476681792 Enrollment ID: I20100506001029 |
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