Organization
L KEITH HANSON PLLC
Active
Other names
Community Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MELODIE WHITE (ADMINISTRATOR)
(509) 689-2525
Entity
Organization
Contact information
Practice address
520 W INDIAN AVE, BREWSTER, WA 98812
(509) 689-2525
(509) 689-3247
Mailing address
PO BOX 337, BREWSTER, WA 98812-0337
(509) 689-2525
(509) 689-3247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
503894
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7124779
—
WA
Enumeration date
03/20/2006
Last updated
08/19/2008
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