| Range Community Clinic | |
|
412 E Spokane Falls Blvd Spokane WA 99202-2131 | |
| (509) 505-7481 | |
| Not Available |
| Full Name | Range Community Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 412 E Spokane Falls Blvd, Spokane, Washington |
| Authorized Official Name and Position | Linda Michaelle Guerrero (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5095057481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Range Community Clinic 412 E Spokane Falls Blvd Spokane WA 99202-2131 Ph: (509) 505-7481 | Range Community Clinic 412 E Spokane Falls Blvd Spokane WA 99202-2131 Ph: (509) 505-7481 |
| NPI Number | 1750916953 |
|---|---|
| Provider Enumeration Date | 03/08/2020 |
| Last Update Date | 12/07/2021 |
| Medicare PECOS PAC ID | 3870902265 |
|---|---|
| Medicare Enrollment ID | O20210517000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750916953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
| Provider Name | Paula Dygert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609853993 PECOS PAC ID: 4486621919 Enrollment ID: I20160921001517 |
| Provider Name | Luis R Manriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174969729 PECOS PAC ID: 2769623297 Enrollment ID: I20170602002333 |
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