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Organization

CHEWELAH ASSOCIATED PHYSICIANS PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. THOMAS JOHN BOONE MD (CEO)
(509) 935-8711
Entity
Organization

Contact information

Practice address
410 E KING ST, CHEWELAH, WA 99109-0137
(509) 935-8711
(509) 935-4882
Mailing address
PO BOX 137, CHEWELAH, WA 99109-0137
(509) 935-8711
(509) 935-4882

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7109173
WA
05
7123300
WA
05
7590946
WA
01
8901404
DEPT OF L&I
WA
01
CN7261
RAILROAD MEDICARE
Enumeration date
01/25/2007
Last updated
06/25/2009
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