Soap Lake Family Medicine
Organization Active NPI Family Medicine Physician · Soap Lake, WA
NPI 1104013556 · NPPES record last updated Mar 31, 2008
Key facts
- NPI
- 1104013556
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- PA10001768 (WA)
- Legal business name
- SOAP LAKE FAMILY MEDICINE
- Practice address
- 127 2ND Ave SW
Soap Lake, WA 98851-0958 - Phone
- (509) 246-0540
- Fax
- (509) 246-0358
- NPI assigned
- Oct 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. John Thomas Bearup, PA
- Title
- Partner
- Phone
- (509) 246-0540
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | PA10001768 | WA | Yes |
Addresses
Primary practice location
127 2ND Ave SW
Soap Lake, WA 98851-0958
Mailing address
127 2ND Ave SW
Soap Lake, WA 98851-0958
Phone (509) 246-0540
Other providers in Soap Lake, WA
- North Central Washington Health LLC
- Paul Armen Odian
- Oliveleaf
- Public Hospital District #4 of Grant County
- Laura Savage
- Soap Lake School District
- Kathi Trantham
All providers in Soap Lake, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.