| John W Fishburne Phd Ps | |
|
23 S Wenatchee Ave Ste 202 Wenatchee WA 98801-2274 | |
| (509) 888-0048 | |
| (509) 888-0923 |
| Full Name | John W Fishburne Phd Ps |
|---|---|
| Speciality | Psychologist |
| Location | 23 S Wenatchee Ave Ste 202, Wenatchee, Washington |
| Authorized Official Name and Position | John Wood Fishburne (OWNER) |
| Authorized Official Contact | 5098880048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John W Fishburne Phd Ps 23 S Wenatchee Ave Ste 202 Wenatchee WA 98801-2274 Ph: (509) 888-0048 | John W Fishburne Phd Ps 23 S Wenatchee Ave Ste 202 Wenatchee WA 98801-2274 Ph: (509) 888-0048 |
| NPI Number | 1669864047 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 07/06/2015 |
| Medicare PECOS PAC ID | 8820301674 |
|---|---|
| Medicare Enrollment ID | O20150722004750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669864047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | John W Fishburne |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003957291 PECOS PAC ID: 1052506706 Enrollment ID: I20101108001377 |
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