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General NPI Number Information
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NPI Number | 1710929252
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Entity Type | Organization
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Legal Business Name | L G STECK MEMORIAL CLINIC P S
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 1299 BISHOP RD
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City | CHEHALIS
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State | WA
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Zip | 98532-8758
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Country | US
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Telephone | 360-748-0211
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Fax | 360-748-8732
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | CHEHALIS
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State | WA
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Zip | 98532-0260
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Country | US
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Telephone | 360-748-0211
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Fax | 360-748-8732
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | TERRY LEE LENO
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Credential |
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Telephone | 360-748-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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