Marys Corner Medical Clinic Inc. Ps

LBN: Marys Corner Medical Clinic Inc. Ps
Marys Corner Medical Clinic Inc. Ps is an health care organization with primary practice located at 4254 Jackson Highway , Chehalis WA 98532. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health, Physician Assistants & Advanced Practice Nursing Providers / Medical. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Marys Corner Medical Clinic Inc. Ps can be contacted via phone (360) 262-3966, or through Inglis, Kimberly H via phone (360) 262-3966.

Contact Information

Primary practice address
4254 Jackson Highway Chehalis WA 98532
Phone: (360) 262-3966
Fax: (360) 262-3967
Website:
Map and Directions
Authorized official contact:
Name: Inglis, Kimberly H
Phone: (360) 262-3966

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00039760 Washington
Ambulatory Health Care Facilities / Rural Health 261QR1300X Washington
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10004588 Washington

Profile Details

NPI number 1104016138
LBN Legal business name Marys Corner Medical Clinic Inc. Ps
DBA Doing business as
Authorized official Inglis, Kimberly H
Entity Organization
Organization subpart 1 No
Enumeration date Jul 26th, 2007
Last updated Apr 26th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104016138 NPPES
Washington MEDICAID 7132764
Washington MEDICAID 1117829
Washington MEDICAID 7132244

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