Healthcare Provider Details

I. General information

NPI: 1891786448
Provider Name (Legal Business Name): LOUISE A SIMONS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E HIGHLAND AVE
CHELAN WA
98816-8631
US

IV. Provider business mailing address

503 E HIGHLAND AVE PO BOX 908
CHELAN WA
98816-8631
US

V. Phone/Fax

Practice location:
  • Phone: 509-682-3300
  • Fax: 509-682-3475
Mailing address:
  • Phone: 509-682-8517
  • Fax: 509-682-9614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00044441
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: