Leslie Canyon Family Medicine, P.s. | |
705 Gage Blvd Suite 200 Richland WA 99352-9701 | |
(509) 628-2331 | |
(509) 628-0537 |
Full Name | Leslie Canyon Family Medicine, P.s. |
---|---|
Speciality | General Practice |
Location | 705 Gage Blvd, Richland, Washington |
Authorized Official Name and Position | Lucien T Megna (PRESIDIENT / CEO) |
Authorized Official Contact | 5096282331 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Leslie Canyon Family Medicine, P.s. 705 Gage Blvd Suite 200 Richland WA 99352-9701 Ph: (509) 628-2331 | Leslie Canyon Family Medicine, P.s. 705 Gage Blvd Suite 200 Richland WA 99352-9701 Ph: (509) 628-2331 |
NPI Number | 1538349030 |
---|---|
Provider Enumeration Date | 11/13/2007 |
Last Update Date | 06/21/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538349030 | NPI | - | NPPES |
7077993 | Medicaid | WA | |
11151316 | Other | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | WA00034155 (Washington) | Primary |
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