Healthcare Provider Details

I. General information

NPI: 1235267527
Provider Name (Legal Business Name): WASHINGTON MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E POLK ST
WASHINGTON IA
52353-1237
US

IV. Provider business mailing address

444 E POLK ST
WASHINGTON IA
52353-1237
US

V. Phone/Fax

Practice location:
  • Phone: 319-653-6601
  • Fax: 319-653-5624
Mailing address:
  • Phone: 319-653-6601
  • Fax: 319-653-5624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. TANYA KAY GREINER
Title or Position: CLINIC MANAGER
Credential:
Phone: 319-653-6601