| Willapa Medical Clinic | |
|
826 Alder St South Bend WA 98586-4900 | |
| (360) 875-5579 | |
| (360) 875-5235 |
| Full Name | Willapa Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 826 Alder St, South Bend, Washington |
| Authorized Official Name and Position | Mary Mcallister (CLINIC MANAGER) |
| Authorized Official Contact | 3608755579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willapa Medical Clinic Po Box 269 826 Alder St. South Bend WA 98586-0269 Ph: (360) 875-5579 | Willapa Medical Clinic 826 Alder St South Bend WA 98586-4900 Ph: (360) 875-5579 |
| NPI Number | 1760582522 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 10/08/2020 |
| Medicare PECOS PAC ID | 8224939301 |
|---|---|
| Medicare Enrollment ID | O20130816000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760582522 | NPI | - | NPPES |
| 0317075 | Other | WA | LABOR & INDUSTRIES-DR. BUBEN |
| 9621491 | Medicaid | WA | |
| 0317062 | Other | WA | LABOR & INDUSTRIES-PFHC |
| 0317067 | Other | WA | LABOR & INDUSTRIES-JARED ABRAMS |
| 1035732 | Medicaid | WA | |
| GAB11482 | Other | WA | RENDERING PIN BUBEN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Harbor Family Practice Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Alder St, South Bend, WA 98586 Phone: 360-875-5339 Fax: 360-875-5042 | |
Willapa Family Medicine Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 Alder St, South Bend, WA 98586 Phone: 360-875-4502 Fax: 360-875-5962 |