Washington Medical Center | |
1351 Jefferson St Ste 16 Washington MO 63090-6449 | |
(636) 202-9400 | |
Not Available |
Full Name | Washington Medical Center |
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Speciality | Clinic/Center |
Location | 1351 Jefferson St Ste 16, Washington, Missouri |
Authorized Official Name and Position | Tina Ryan (PROVIDER) |
Authorized Official Contact | 6362029400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Washington Medical Center 1351 Jefferson St Ste 16 Washington MO 63090-6449 Ph: (636) 202-9400 | Washington Medical Center 1351 Jefferson St Ste 16 Washington MO 63090-6449 Ph: (636) 202-9400 |
NPI Number | 1386229011 |
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Provider Enumeration Date | 03/15/2021 |
Last Update Date | 05/23/2022 |
Medicare PECOS PAC ID | 3971904939 |
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Medicare Enrollment ID | O20210628002675 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386229011 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Tina M Ryan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922470889 PECOS PAC ID: 4486953726 Enrollment ID: I20160728001361 |
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