MEDICARE: FAMILY PLANNING OF CLALLAM COUNTY

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	600258997000	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AB39834	OTHER	WA	MEDICARE ID#
3	AB39835	OTHER	WA	MEDICARE ID#

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	:	1548391964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PLANNING OF CLALLAM COUNTY

Provider Business Mailing Address
First Line	:	PO BOX 927
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-0160
Country	:	US
Telephone Number	:	360-452-2954
Fax Number	:	360-457-7683

Provider Business Practice Location Address
First Line	:	1106 E 1ST ST
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-4317
Country	:	US
Telephone Number	:	360-452-2954
Fax Number	:	360-457-7683

Authorized Official
Title or Position	:	INTERIM EXECUTIVE DIRECTOR
Name	:	CHERIE REEVES SPERR
Credential	:	MS
Telephone Number	:	360-452-2954

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/14/2008

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Directions to “FAMILY PLANNING OF CLALLAM COUNTY ” Practice Location

Language	Start Address	Practice Location

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