MEDICARE: JOHN VAL RICE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	P0412	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255348074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN VAL RICE DPM

Provider Business Mailing Address
First Line	:	1812 N 13TH LOOP RD
Second Line	:
City	:	SHELTON
State	:	WA
Zip	:	98584-2169
Country	:	US
Telephone Number	:	360-427-0366
Fax Number	:	360-427-5879

Provider Business Practice Location Address
First Line	:	1812 N 13TH LOOP RD
Second Line	:
City	:	SHELTON
State	:	WA
Zip	:	98584-2169
Country	:	US
Telephone Number	:	360-427-0366
Fax Number	:	360-427-5879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	06/21/2008

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