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General NPI Number Information
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NPI Number | 1003962408
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Entity Type | Organization
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Legal Business Name | FREELAND CLINIC INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 1660 E LAYTON STREET
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City | FREELAND
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State | WA
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Zip | 98249-0279
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Country | US
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Telephone | 360-331-5115
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Fax | 360-331-7505
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Provider Business Mailing Address
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Address Line | PO BOX 279
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City | FREELAND
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State | WA
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Zip | 98249-0279
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Country | US
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Telephone | 360-331-5115
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Fax | 360-331-7505
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Authorized Official
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Title or Position | PHSYICIAN
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Name | DR. PATRICE JULIANNE ONEILL
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Credential | MD
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Telephone | 360-331-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD0013247
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License Number State | WA
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