| Chattaroy Family Medicine Pllc | |
|
23 E. Crawford Ave. Deer Park WA 99006 | |
| (509) 276-2554 | |
| (509) 276-2564 |
| Full Name | Chattaroy Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 23 E. Crawford Ave., Deer Park, Washington |
| Authorized Official Name and Position | Basil M Griffin (PRESIDENT) |
| Authorized Official Contact | 5092762554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chattaroy Family Medicine Pllc Po Box 1304 Deer Park WA 99006-1304 Ph: (509) 276-2554 | Chattaroy Family Medicine Pllc 23 E. Crawford Ave. Deer Park WA 99006 Ph: (509) 276-2554 |
| NPI Number | 1851613749 |
|---|---|
| Provider Enumeration Date | 02/19/2010 |
| Last Update Date | 12/01/2016 |
| Medicare PECOS PAC ID | 4789718115 |
|---|---|
| Medicare Enrollment ID | O20100819001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851613749 | NPI | - | NPPES |
| 1851613749 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00049372 (Washington) | Primary |
| Provider Name | Basil M Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245206358 PECOS PAC ID: 4183799224 Enrollment ID: I20080825000117 |
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