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General NPI Number Information
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NPI Number | 1356536817
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE OF PORT ANGELES PLLC
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 920 CAROLINE ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3910
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Country | US
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Telephone | 360-452-7891
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Fax | 360-782-7891
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Provider Business Mailing Address
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Address Line | 303 W 8TH ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-5904
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Country | US
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Telephone | 360-452-7891
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Fax | 360-452-8087
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CARLENE RINGIUS
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Credential |
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Telephone | 360-452-7891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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