| Lewis County Community Health Services | |
|
273 Sussex Ave E Tenino WA 98589-9359 | |
| (360) 264-5665 | |
| (360) 264-5666 |
| Full Name | Lewis County Community Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 273 Sussex Ave E, Tenino, Washington |
| Authorized Official Name and Position | Steven C Clark (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3603309595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis County Community Health Services 2690 Ne Kresky Ave Chehalis WA 98532-2412 Ph: (360) 330-9595 | Lewis County Community Health Services 273 Sussex Ave E Tenino WA 98589-9359 Ph: (360) 264-5665 |
| NPI Number | 1881135499 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 03/15/2017 |
| Medicare PECOS PAC ID | 6002803749 |
|---|---|
| Medicare Enrollment ID | O20170526000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881135499 | NPI | - | NPPES |
| G8801670 | Other | WA | MEDICARE PART B |
| 7126972 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 602312048 (Washington) | Primary |
Tenino Family Practice Pllc 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 | |
Leyton Endicott Jump 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 |