| Wahluke Clinic | |
|
601 Government Way Mattawa WA 99349 | |
| (509) 932-3535 | |
| (509) 488-9939 |
| Full Name | Wahluke Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 Government Way, Mattawa, Washington |
| Authorized Official Name and Position | Joshua Bunch (CFO) |
| Authorized Official Contact | 5094885250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wahluke Clinic 1515 E Columbia St Othello WA 99344-1846 Ph: (509) 488-5256 | Wahluke Clinic 601 Government Way Mattawa WA 99349 Ph: (509) 932-3535 |
| NPI Number | 1053539890 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 07/11/2023 |
| Medicare PECOS PAC ID | 4486564309 |
|---|---|
| Medicare Enrollment ID | O20040427000342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053539890 | NPI | - | NPPES |
| 50D9963406 | Other | WA | CLIA # |
| 8908941 | Other | WA | CRIME VICTIMS # |
| 7107675 | Other | WA | UGS MDC DSHS CROSSOVER |
| 7900624 | Other | WA | TAKE CHARGE # |
| 0135012 | Other | WA | DEPT OF L&I |
| 7096555 | Medicaid | WA | |
| 7407927 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |
Mattawa Community Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 Government Road, Mattawa, WA 99349 Phone: 509-932-4499 Fax: 509-932-5363 | |
Columbia Basin Health Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Government Way, Mattawa, WA 99349 Phone: 509-488-5256 Fax: 509-488-9939 |