| Mcmc Specialties Goldendale | |
|
317 Sanders Way Goldendale WA 98620-9059 | |
| (541) 296-1111 | |
| Not Available |
| Full Name | Mcmc Specialties Goldendale |
|---|---|
| Speciality | Clinic/Center |
| Location | 317 Sanders Way, Goldendale, Washington |
| Authorized Official Name and Position | Dennis Knox (CORPORATE OFFICER CEO) |
| Authorized Official Contact | 5412967273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcmc Specialties Goldendale Po Box 1520 The Dalles OR 97058-8003 Ph: (541) 506-6530 | Mcmc Specialties Goldendale 317 Sanders Way Goldendale WA 98620-9059 Ph: (541) 296-1111 |
| NPI Number | 1679086516 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 06/19/2023 |
| Medicare PECOS PAC ID | 3779487251 |
|---|---|
| Medicare Enrollment ID | O20180115000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679086516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Washington) | Primary |
| Provider Name | Marc Paul |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750375390 PECOS PAC ID: 1557398419 Enrollment ID: I20060307000328 |
| Provider Name | Kevin S Wei |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962418574 PECOS PAC ID: 0547285587 Enrollment ID: I20091113000397 |
| Provider Name | David Guarraia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710196811 PECOS PAC ID: 5395806129 Enrollment ID: I20180116002427 |
| Provider Name | Matthew Labarbera |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174728968 PECOS PAC ID: 6800962929 Enrollment ID: I20190430000793 |
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