| |
235 Main Street Waitsburg WA 99361 | |
(509) 337-6311 | |
(509) 337-6011 |
Full Name | |
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Speciality | Clinic/Center |
Location | 235 Main Street, Waitsburg, Washington |
Authorized Official Name and Position | Matt Minor (CFO) |
Authorized Official Contact | 5093822531 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1012 South Third Street Dayton WA 99328 Ph: (509) 382-2531 | 235 Main Street Waitsburg WA 99361 Ph: (509) 337-6311 |
NPI Number | 1215018346 |
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Provider Enumeration Date | 10/17/2006 |
Last Update Date | 04/26/2022 |
Medicare PECOS PAC ID | 5597653758 |
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Medicare Enrollment ID | O20101007000177 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215018346 | NPI | - | NPPES |
1043278 | Medicaid | WA |