| Bogachiel Clinic | |
|
390 Founders Way Forks WA 98331-9062 | |
| (360) 374-6271 | |
| (360) 374-9781 |
| Full Name | Bogachiel Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 390 Founders Way, Forks, Washington |
| Authorized Official Name and Position | Heidi Anderson (CEO) |
| Authorized Official Contact | 3603746271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bogachiel Clinic 390 Founders Way Forks WA 98331 Ph: (360) 374-6271 | Bogachiel Clinic 390 Founders Way Forks WA 98331-9062 Ph: (360) 374-6271 |
| NPI Number | 1285683052 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 01/11/2022 |
| Certification Date | 01/11/2022 |
| Medicare PECOS PAC ID | 1557256468 |
|---|---|
| Medicare Enrollment ID | O20090522000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285683052 | NPI | - | NPPES |
| 7113442 | Medicaid | WA | |
| 7047459 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H-054 (Washington) | Primary |
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