CLINIC AT ROYAL CITY (NPI# 1962586503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962586503 |
| Entity Type | Organization |
| Organization Name | CLINIC AT ROYAL CITY |
| Other Organization Name | CLINIC AT ROYAL CITY |
| Practice Address |
101 Camelia St Nw Royal City WA 99357 |
| Mailing Address |
Po Box 1028 Royal City WA 99357-1028 |
| Practice Telephone | 5093461447 |
| Practice Fax Number | 5093461481 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST) |
| Authorized Official Telephone | 8006540889 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | MD00010548 | WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4928137 | 01 | |
| WA | 8213605 | 05 |
| Other Name | Type Code |
|---|---|
| CLINIC AT ROYAL CITY | Doing Business As Name - Organization |
| Street Address |
101 CAMELIA ST NW |
| City | ROYAL CITY |
| State | WA |
| Zip Code | 99357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811922982 | John P Clark | Physician Assistant | 101 Camelia St Nw, Royal City, WA 99357 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720426596 | Ngoc Huu Quyuh Tran | Physician Assistant | 103 Camelia St Nw, Royal City, WA 99357 | 2013-06-13 |
| 1417297409 | Elaine Prest | Registered Nurse | 230 Wildflower St. Ne, Royal City, WA 99357 | 2013-02-27 |
| 1548507338 | Wenatchee Valley Hospital | Family Medicine | 103 Camelia St. N.w., Royal City, WA 99357 | 2013-01-14 |
| 1629360946 | Robyn J Valdez | Massage Therapist | 124 Fern Street, Royal City, WA 99357 | 2011-05-04 |
| 1740422666 | County of Grant | Ambulance | 336 Camelia St Nw, Royal City, WA 99357 | 2009-03-25 |
| 1174632954 | Laura Broussard | Nurse Practitioner | 103 Camelia St, Royal City, WA 99357 | 2006-08-29 |
| 1417978842 | Bruce R Douglas | Physician Assistant | 103 Camelia St., Royal City, WA 99357 | 2006-07-21 |
| 1710075254 | Grant County Fire District No 10 | Ambulance | 336 Camelia St Ne, Royal City, WA 99357-0220 | 2006-10-10 |
| 1538597224 | Louise Ann Andersen | Licensed Practical Nurse | 224 Wildflower Ave Ne, Royal City, WA 99357-0364 | 2013-10-16 |
| 1235528670 | Kathryn Kannely I | Registered Nurse | 901 Ahlers Rd, Royal City, WA 99357-0486 | 2015-01-22 |
| Find all providers in zip 99357 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890268 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 10541 Ne 4th St, Bellevue, WA 98004-5023 | 2020-08-10 |
| 1770193294 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 4555 Stone Way N, Seattle, WA 98103-6647 | 2020-08-10 |
| 1386254811 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 123 Broadway E Ste A, Seattle, WA 98102-5711 | 2020-08-10 |
| 1538779137 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 781 W Columbia Way, Vancouver, WA 98660 | 2020-08-07 |
| 1659981272 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 15911 Westminister Way N., Shoreline, WA 98113 | 2020-08-07 |
| 1841800752 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 517 Union St, Seattle, WA 98101-2308 | 2020-08-05 |
| 1437769320 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 10425 Ne 8th St, Bellevue, WA 98004-4346 | 2020-08-05 |
| 1184234072 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2038 Nw Market St, Seattle, WA 98107-4012 | 2020-08-05 |
| 1619587482 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 4012 Sw Alaska St, Seattle, WA 98116-4529 | 2020-08-05 |
| 1083224919 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 1909 Queen Anne Ave N, Seattle, WA 98109-2549 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
| City | ROYAL CITY |
| Zip Code | 99357 |
Please comment or provide details below to improve the information on CLINIC AT ROYAL CITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.