Organization
CASTLE ROCK PEDIATRICS AND FAMILY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REINHILD AYOUB (OWNER/PRACTITIONER)
(360) 274-2353
Entity
Organization
Contact information
Practice address
139 FIRST AVENUE SW, CASTLE ROCK, WA 98611-0160
(360) 274-2353
(360) 274-2354
Mailing address
PO BOX 160, CASTLE ROCK, WA 98611-0160
(360) 274-2353
(360) 274-2354
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
601 929 001 11
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7094261
—
WA
Enumeration date
12/18/2007
Last updated
11/25/2008
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