| Clyde Arthur Hanson, DO | |
|
600 E Main St, Elma, WA 98541-9560 | |
| (360) 346-2299 | |
| (360) 346-2157 |
| Full Name | Clyde Arthur Hanson |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 600 E Main St, Elma, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760540801 | NPI | - | NPPES |
| 805770200 | Medicaid | ID | |
| 000010028719 | Other | ID | REGENCE BS IDAHO |
| 8434847 | Medicaid | WA | |
| 141315 | Other | WA | WA LABOR & INDUSTRIES |
| 601415900 | Other | DEEIOC | |
| S3168 | Other | ID | BC OF ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | O-231 (Idaho) | Secondary |
| 207P00000X | Emergency Medicine | OP60768791 (Washington) | Primary |
| Entity Name | Syringa Health And Wellness Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588309900 PECOS PAC ID: 5395124622 Enrollment ID: O20220616002199 |
| Mailing Address | Practice Location Address |
|---|---|
| Clyde Arthur Hanson, DO 229 S 7th St, St Maries, ID 83861-1803 Ph: (205) 245-5551 | Clyde Arthur Hanson, DO 600 E Main St, Elma, WA 98541-9560 Ph: (360) 346-2299 |
Dr. Benjamin E. Good, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 E. Main Street, Elma, WA 98541 Phone: 360-346-2222 Fax: 360-346-2161 | |
Dr. John Russell Ringquist, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 600 E Main St Ste A, Elma, WA 98541 Phone: 360-346-2222 Fax: 360-234-6621 |