Healthcare Provider Details

I. General information

NPI: 1548391964
Provider Name (Legal Business Name): FAMILY PLANNING OF CLALLAM COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 E 1ST ST
PORT ANGELES WA
98362-4317
US

IV. Provider business mailing address

PO BOX 927
PORT ANGELES WA
98362-0160
US

V. Phone/Fax

Practice location:
  • Phone: 360-452-2954
  • Fax: 360-457-7683
Mailing address:
  • Phone: 360-452-2954
  • Fax: 360-457-7683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number600258997000
License Number StateWA

VIII. Authorized Official

Name: CHERIE REEVES SPERR
Title or Position: INTERIM EXECUTIVE DIRECTOR
Credential: MS
Phone: 360-452-2954