L. G. Steck Memorial Clinic, P. S.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

L. G. STECK MEMORIAL CLINIC, P. S.

Practice address

1707 Cooks Hill Rd
Centralia, WA 98531-9071

Phone

(360) 736-1965

Fax

(360) 736-2539

NPI assigned

Jun 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Harley Daniel Miller, MD

Title

Seceratary

Phone

(360) 748-0211

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CENTRALIA SPECIALTY CENTER Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Rural health clinic certification: CCN 503900

Legal name

CENTRALIA SPECIALTY CENTER

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 22, 2005

Last certification

Mar 25, 2013

Ownership / control type

1B

Facility address

1707 Cooks Hill Road
Centralia, WA 98531

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kaitlin G Bock, ARNP

  • Family Nurse Practitioner
  • Chehalis, WA
  • NPI 1720248701
  NPD (past)
• Robin A Rice, PA-C

  • Physician Assistant
  • Napavine, WA
  • NPI 1316032030
  NPD (past)
• Ronald J Williams, M. D.

  • Emergency Medicine Physician
  • Chehalis, WA
  • NPI 1780779413
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1962664003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320260",
            "telephone_number": "360-736-1965",
            "fax_number": "360-736-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319071",
            "telephone_number": "360-736-1965",
            "fax_number": "360-736-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. G. STECK MEMORIAL CLINIC, P. S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "HARLEY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "SECERATARY",
        "authorized_official_telephone_number": "360-748-0211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7131733",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRALIA SPECIALTY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James C. Krupke
• Anesse L. Kuehl, D.P.T.
• Jason Kugel, PT
• Julie Dianne Kugel, OTR/L
• Katie Elizabeth Kunnen, D.O.
• Laboratory Corporation of America
• Laboratory Corporation of America
• Laboratory Corporation of America
• Cyndi Labrec
• Gage Edward Lafferty

• Rural Health Clinic/Center in Centralia, WA
• Providers in Centralia, WA by specialty
• Rural Health Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.