MEDICARE: WOMEN'S HEALTH CENTER, INC. PS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336172097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMEN'S HEALTH CENTER, INC. PS

Provider Business Mailing Address
First Line	:	702 SW COLEWOOD LN
Second Line	:
City	:	NORMANDY PARK
State	:	WA
Zip	:	98166-3938
Country	:	US
Telephone Number	:	206-248-0854
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 SW COLEWOOD LN
Second Line	:
City	:	NORMANDY PARK
State	:	WA
Zip	:	98166-3938
Country	:	US
Telephone Number	:	206-248-0854
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRADLEY WILLIAM KLEBS
Credential	:	M.D.
Telephone Number	:	206-248-0854

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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