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HEALTHSOURCE OF MOSES LAKE NPI 1003212895


NPI Information

NPI: 1003212895
Provider Name: HEALTHSOURCE OF MOSES LAKE
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
420 W 3RD AVE
MOSES LAKE, WA
ZIP 98837
Phone: (509) 765-0638
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HEALTHSOURCE OF MOSES LAKE is a clinic center in Moses Lake, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). HEALTHSOURCE OF MOSES LAKE NPI is 1003212895. The provider is registered as an organization entity type.

The provider's business location address is:

420 W 3RD AVE
MOSES LAKE, WA
ZIP 98837-908
Phone: (509) 765-0638
Fax: (509) 765-3891

The provider's authorized official is Gregg Moyle Jones .
The authorized official title is President and has the following contact phone number (509) 765-0638.

The enumeration date for this NPI number is 11/6/2014 and was last updated on 11/6/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterCH00003167WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11598852840MEDICARE UPINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/15/2022

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.