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NPI 1730289596

NPI 1730289596 : WHITMAN MEDICAL GROUP PS : COLFAX, WA

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General NPI Number Information
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    NPI Number           |    1730289596
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    Entity Type          |    Organization 
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    Legal Business Name  |    WHITMAN MEDICAL GROUP PS 
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Dates
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    Enumeration Date     |    09/22/2006
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    Last Update Date     |    12/11/2008
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Provider Practice Location Address
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    Address Line         |    1210 W FAIRVIEW ST 
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    City                 |    COLFAX
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    State                |    WA
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    Zip                  |    99111-9552
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    Country              |    US
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    Telephone            |    509-397-4717
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    Fax                  |    509-397-3501
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Provider Business Mailing Address
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    Address Line         |    1210 W FAIRVIEW ST 
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    City                 |    COLFAX
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    State                |    WA
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    Zip                  |    99111-9552
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    Country              |    US
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    Telephone            |    509-397-4717
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    Fax                  |    509-397-3501
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     NATHAN JAMES HYMAS 
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    Credential           |    
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    Telephone            |    509-397-4717
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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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