Organization
PALOUSE MEDICAL PS
Active
Other names
Pullman ReadyCare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE M FOSBACK MD (PRESIDENT)
(509) 332-2517
Entity
Organization
Contact information
Practice address
825 SE BISHOP BLVD STE 200, PULLMAN, WA 99163-5537
(509) 332-2517
(509) 334-9247
Mailing address
825 SE BISHOP BLVD STE 200, PULLMAN, WA 99163-5537
(509) 332-2517
(509) 334-9247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003202800
—
ID
05
—
7085418
—
WA
Enumeration date
07/01/2006
Last updated
08/17/2023
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