Provider Demographics
NPI:1386861615
Name:FOOT & ANKLE CENTER OF WENATCHEE, P.S.
Entity Type:Organization
Organization Name:FOOT & ANKLE CENTER OF WENATCHEE, P.S.
Other - Org Name:FOOT HEALTH SERVICES AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:509-662-2970
Mailing Address - Street 1:616 N CHELAN AVE
Mailing Address - Street 2:SUITE ASC
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2025
Mailing Address - Country:US
Mailing Address - Phone:509-662-2970
Mailing Address - Fax:509-665-9808
Practice Address - Street 1:616 N CHELAN AVE
Practice Address - Street 2:SUITE ASC
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2025
Practice Address - Country:US
Practice Address - Phone:509-662-2970
Practice Address - Fax:509-665-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAFX00057275261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7113111Medicaid
WAPO0060763OtherPALMETTO GBA RAILROAD MEDICARE PART B
WA35676OtherGROUP # FOR ASC FOR L&I
WAPO0060763OtherPALMETTO GBA RAILROAD MEDICARE PART B
WA7113111Medicaid