Organization
L G STECK MEMORIAL CLINIC P S
Active
Other names
Steck Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LEE LENO (CHIEF FINANCIAL OFFICER)
(360) 748-0211
Entity
Organization
Contact information
Practice address
1299 BISHOP RD, CHEHALIS, WA 98532-8758
(360) 748-0211
(360) 748-8732
Mailing address
PO BOX 1267, CHEHALIS, WA 98532-0260
(360) 748-0211
(360) 748-8732
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
WA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032700
LABOR & INDUSTRIES
WA
01
—
02025138
MEDICAID CHIROPRACTOR
WA
01
—
0568510001
DMERC SUPPLIER ID
WA
05
—
7069883
—
WA
01
—
7074131
MEDICAID NAPAVINE MEDICAL
WA
01
—
7098767
MEDICAID AUDIOLOGY
WA
01
—
7131725
MEDICAID L G STECK MEMORI
WA
01
—
7131733
MEDICAID CENTRALIA SPECIA
WA
01
—
9039751
MEDICAID DME
WA
01
—
C46630
RAILROAD MEDICARE
WA
Enumeration date
06/11/2006
Last updated
10/21/2021
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