Organization
PACIFIC COUNTY HOSPITAL DISTRICT #2
Active
Other names
Southbend Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY STONE (CFO)
(360) 875-4508
Entity
Organization
Contact information
Practice address
800 ALDER STREET, SOUTHBEND, WA 98586
(360) 875-5339
(360) 875-6167
Mailing address
PO BOX 1370, 800 ALDER STREET, SOUTHBEND, WA 98586
(360) 875-5339
(360) 875-6167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102957
—
WA
Enumeration date
01/02/2007
Last updated
08/22/2020
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