Organization
PACIFIC COUNTY HOSPITAL DISTRICT 2
Active
Other names
Willapa Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MCALLISTER (CLINIC MANAGER)
(360) 875-5579
Entity
Organization
Contact information
Practice address
826 ALDER ST, SOUTH BEND, WA 98586-4900
(360) 875-5579
(360) 875-5235
Mailing address
PO BOX 269, 826 ALDER ST., SOUTH BEND, WA 98586-0269
(360) 875-5579
(360) 875-5235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0317062
LABOR & INDUSTRIES-PFHC
WA
01
—
0317067
LABOR & INDUSTRIES-JARED ABRAMS
WA
01
—
0317075
LABOR & INDUSTRIES-DR. BUBEN
WA
05
—
1035732
—
WA
05
—
9621491
—
WA
01
—
GAB11482
RENDERING PIN BUBEN
WA
Enumeration date
09/22/2006
Last updated
10/08/2020
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