Organization
CLINICARE OF PORT ANGELES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DECK DENNIS (CLINIC MANAGER)
(360) 452-5000
Entity
Organization
Contact information
Practice address
621 E FRONT ST, PORT ANGELES, WA 98362-3319
(360) 452-5000
(360) 452-0228
Mailing address
621 E FRONT ST, PORT ANGELES, WA 98362-3319
(360) 452-5000
(360) 452-0228
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
601555884
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7065543
—
WA
01
—
71530
WA STATE L&I
WA
Enumeration date
05/30/2008
Last updated
05/30/2008
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