Washtucna Medical Clinic | |
545 Se Church Street Washtucna WA 99371 | |
(509) 646-3290 | |
Not Available |
Full Name | Washtucna Medical Clinic |
---|---|
Speciality | Family Medicine |
Location | 545 Se Church Street, Washtucna, Washington |
Authorized Official Name and Position | Tamra Combs (CREDENTIALING) |
Authorized Official Contact | 5096591200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Washtucna Medical Clinic 903 S Adams St Ritzville WA 99169-2227 Ph: (509) 646-3290 | Washtucna Medical Clinic 545 Se Church Street Washtucna WA 99371 Ph: (509) 646-3290 |
NPI Number | 1104849058 |
---|---|
Provider Enumeration Date | 07/25/2006 |
Last Update Date | 06/04/2024 |
Medicare PECOS PAC ID | 8022906122 |
---|---|
Medicare Enrollment ID | O20041116000473 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104849058 | NPI | - | NPPES |
508542 | Other | MEDICARE | |
8157364 | Medicaid | WA | |
0050906 | Other | WA | WA L&I |
0051688 | Other | WA | WA L&I |
0203688 | Other | WA | WA L&I |
0148592 | Other | WA | WA L&I |
0156841 | Other | WA | WA L&I |
8119547 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |