| |
1012 South Third Street Dayton WA 99328 | |
(509) 382-3200 | |
(509) 382-2748 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1012 South Third Street, Dayton, Washington |
Authorized Official Name and Position | Matt Minor (CFO) |
Authorized Official Contact | 5093822531 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1012 South Third Street Dayton WA 99328 Ph: (509) 382-3200 | 1012 South Third Street Dayton WA 99328 Ph: (509) 382-3200 |
NPI Number | 1518044551 |
---|---|
Provider Enumeration Date | 11/01/2006 |
Last Update Date | 04/26/2022 |
Medicare PECOS PAC ID | 5597653758 |
---|---|
Medicare Enrollment ID | O20101007000021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518044551 | NPI | - | NPPES |
1044538 | Medicaid | WA |