| Tenino Family Practice | |
|
273 Sussex Ave E Tenino WA 98589-9359 | |
| (360) 264-5665 | |
| (360) 264-5666 |
| Full Name | Tenino Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 273 Sussex Ave E, Tenino, Washington |
| Authorized Official Name and Position | Leyton Endicott Jump (OWNER) |
| Authorized Official Contact | 3602645665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tenino Family Practice Po Box 4020 Tenino WA 98589-4020 Ph: (360) 264-5665 | Tenino Family Practice 273 Sussex Ave E Tenino WA 98589-9359 Ph: (360) 264-5665 |
| NPI Number | 1851357008 |
|---|---|
| Provider Enumeration Date | 04/25/2006 |
| Last Update Date | 06/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851357008 | NPI | - | NPPES |
| 122559 | Other | WA | LABOR & INDUSTRIES |
| 7102478 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00022762 (Washington) | Primary |
Leyton Jump Md Sole Member Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 273 Sussex Ave E, Tenino, WA 98589 Phone: 360-264-5665 Fax: 360-264-5666 | |
Valley View Health Center - Tenino Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 273 Sussex Ave E, Tenino, WA 98589 Phone: 360-264-5665 Fax: 360-264-5666 |