| Providence Health & Services Washington (pmg Se Wa) - Express Care | |
|
1705 Se Meadowbrook Blvd Suite 2 College Place WA 99324-1756 | |
| (509) 987-2450 | |
| Not Available |
| Full Name | Providence Health & Services Washington (pmg Se Wa) - Express Care |
|---|---|
| Speciality | General Practice |
| Location | 1705 Se Meadowbrook Blvd, College Place, Washington |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Washington (pmg Se Wa) - Express Care Po Box 32 Liberty Lake WA 99019-0032 Ph: () - | Providence Health & Services Washington (pmg Se Wa) - Express Care 1705 Se Meadowbrook Blvd Suite 2 College Place WA 99324-1756 Ph: (509) 987-2450 |
| NPI Number | 1023563897 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 11/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023563897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Wwu Campus Health & Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 S College Ave, Suite 101, College Place, WA 99324 Phone: 509-527-2425 Fax: 509-527-2426 | |
Walla Walla Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 376 Se Highland Park Dr, College Place, WA 99324 Phone: 509-529-0376 | |
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