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General NPI Number Information
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NPI Number | 1821545443
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Entity Type | Organization
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Legal Business Name | CENTRAL WASHINGTON MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 520 W INDIAN AVENUE
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City | BREWSTER
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State | WA
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Zip | 98812
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Country | US
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Telephone | 509-689-2525
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Fax | 509-689-3247
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Provider Business Mailing Address
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Address Line | PO BOX 517
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City | BREWSTER
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State | WA
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Zip | 98812-0517
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Country | US
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Telephone | 509-689-2525
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Fax | 509-689-3247
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MELODIE WHITE
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Credential |
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Telephone | 509-689-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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