Organization
DAVID C WYNECOOP MEMORIAL CLINIC DHHS IHS WELLPINIT SERVICE UNIT
Active
Other names
WELLPINIT INDIAN HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
BILL N WILES (ADMINISTRATIVE OFFICER)
(509) 258-4517
Entity
Organization
Contact information
Practice address
6203 AGENCY LOOP RD, WELLPINIT, WA 99040-0357
(509) 258-4517
(509) 258-7152
Mailing address
6203 AGENCY LOOP ROAD, PO BOX 357, WELLPINIT, WA 99040-0357
(509) 258-4517
(509) 258-7152
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4926309
PHARMACY NCPDP NUMBER
WA
05
—
6021166
—
WA
05
—
7100407
—
WA
Enumeration date
10/06/2006
Last updated
08/22/2020
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