Organization
LAKE CHELAN CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA BERG (ADMINISTRATOR)
(509) 682-2511
Entity
Organization
Contact information
Practice address
219 E JOHNSON AVE, CHELAN, WA 98816-9160
(509) 682-2511
(509) 682-2515
Mailing address
PO BOX 368, CHELAN, WA 98816-0368
(509) 682-2511
(509) 682-2515
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
503851
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7115603
—
WA
Enumeration date
03/21/2006
Last updated
10/20/2010
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