Organization
MID-COLUMBIA FAMILY PHYSICIANS,P.S.
Active
Organization
MID-COLUMBIA FAMILY PHYSICIANS,P.S.
Active
Other names
NorthShore Medical Group, MID COLUMBIA FAMILY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R ALLEN LABERGE MD (PRESIDENT)
(509) 493-2133
Entity
Organization
Contact information
Practice address
875 ROCK CRK DRIVE SW, STEVENSON, WA 98648-0875
(509) 427-4212
(509) 427-4955
Mailing address
PO BOX 1519, WHITE SALMON, WA 98672-1519
(509) 493-2133
(509) 495-9538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
600416746
WA
261QR1300X
Rural Health Clinic/Center
Primary
600416746
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7033376
—
WA
05
—
7065576
—
WA
Enumeration date
05/11/2007
Last updated
11/16/2018
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