| South Bend Clinic Dba Riverview Health Center | |
|
300 Ocean Ave Raymond WA 98577-3016 | |
| (360) 942-3040 | |
| (360) 942-3955 |
| Full Name | South Bend Clinic Dba Riverview Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 300 Ocean Ave, Raymond, Washington |
| Authorized Official Name and Position | Rhondi R Vail-lush (MANAGER/CORPORATE SECRETARY) |
| Authorized Official Contact | 3609424562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Bend Clinic Dba Riverview Health Center Po Box 666 Raymond WA 98577-0666 Ph: (360) 942-3040 | South Bend Clinic Dba Riverview Health Center 300 Ocean Ave Raymond WA 98577-3016 Ph: (360) 942-3040 |
| NPI Number | 1750465365 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750465365 | NPI | - | NPPES |
| 7840408 | Medicaid | WA | |
| 7086515 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OP00000626 (Washington) | Primary |
Lewis County Community Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Ocean Ave, Raymond, WA 98577 Phone: 360-942-3040 Fax: 360-942-3955 |