| Odessa Clinic | |
|
510 E. Amende Odessa WA 99159 | |
| (509) 982-2611 | |
| (509) 982-2675 |
| Full Name | Odessa Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 510 E. Amende, Odessa, Washington |
| Authorized Official Name and Position | John Serle (CEO) |
| Authorized Official Contact | 5099822611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Odessa Clinic Po Box 190 Odessa WA 99159 Ph: (509) 982-2611 | Odessa Clinic 510 E. Amende Odessa WA 99159 Ph: (509) 982-2611 |
| NPI Number | 1740317544 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 04/20/2021 |
| Medicare PECOS PAC ID | 1052209152 |
|---|---|
| Medicare Enrollment ID | O20040309001439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740317544 | NPI | - | NPPES |
| 7013337 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | A.b. Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194746826 PECOS PAC ID: 5092723577 Enrollment ID: I20060324000130 |
| Provider Name | Elizabeth M Stuhlmiller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477816502 PECOS PAC ID: 6305162009 Enrollment ID: I20150223001484 |
Odessa Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 E Amende, Odessa, WA 99159 Phone: 509-982-2611 Fax: 509-982-2159 |