Organization
RAINBOW EURALYPTUS INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LABRECQUE (ACCTS. MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
1016 TACOMA AVE, SUNNYSIDE, WA 98944-2263
(509) 837-1500
Mailing address
3196 WILLOW CREEK RD, SUITE A 103 BOX 245, PRESCOTT, AZ 86301-6689
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
OP60309571
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP60309571
WA LIC
WA
Enumeration date
12/27/2012
Last updated
12/27/2012
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