Organization
PPM WASHINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER L TUELLER (SECRETARY)
(208) 207-2726
Entity
Organization
Contact information
Practice address
1370 BRIDGE ST, CLARKSTON, WA 99403-2332
(208) 401-1400
Mailing address
1675 E RIVERSIDE DR STE 200, EAGLE, ID 83616-7473
(208) 401-1400
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
06/06/2025
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