MEDICARE: THREE RIVERS URGENT CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1255051389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THREE RIVERS URGENT CARE LLC

Provider Business Mailing Address
First Line	:	1507 BOMBING RANGE RD STE A
Second Line	:
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353-8001
Country	:	US
Telephone Number	:	509-591-4003
Fax Number	:	509-591-4123

Provider Business Practice Location Address
First Line	:	1507 BOMBING RANGE
Second Line	:
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353
Country	:	US
Telephone Number	:	509-943-2366
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MICHAEL J PATTILLO
Credential	:	MD
Telephone Number	:	509-943-3196

Provider Enumeration Date	:	08/30/2022
Last Update Date	:	06/01/2026

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