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Organization
SUNNYSIDE FAMILY MEDICINE, PC
Active
Organization
SUNNYSIDE FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OLGA MEDELEZ (RECEPTION/BILLING)
(509) 837-6681
Entity
Organization
Contact information
Practice address
2240 E LINCOLN AVE, SUNNYSIDE, WA 98944-2487
(509) 837-6681
(509) 839-0075
Mailing address
2240 E LINCOLN AVE, SUNNYSIDE, WA 98944-2487
(509) 837-6681
(509) 839-0075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001175
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052792
L&I NUMBER
WA
01
—
0146393
L&I NUMBER
WA
01
—
0146394
L&I NUMBER
WA
05
—
1057496
—
WA
01
—
112305
L&I GROUP NUMBER
WA
05
—
7081540
—
WA
05
—
8264582
—
WA
01
—
8935331
CRIME VICTIMS NUMBER
WA
05
—
9616897
—
WA
Enumeration date
03/13/2007
Last updated
12/09/2016
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