Provider Demographics
NPI:1235267527
Name:WASHINGTON MEDICAL CLINIC
Entity Type:Organization
Organization Name:WASHINGTON MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:GREINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-653-6601
Mailing Address - Street 1:444 E POLK ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1237
Mailing Address - Country:US
Mailing Address - Phone:319-653-6601
Mailing Address - Fax:319-653-5624
Practice Address - Street 1:444 E POLK ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1237
Practice Address - Country:US
Practice Address - Phone:319-653-6601
Practice Address - Fax:319-653-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA12690Medicare ID - Type Unspecified