Provider Demographics
NPI:1548391964
Name:FAMILY PLANNING OF CLALLAM COUNTY
Entity Type:Organization
Organization Name:FAMILY PLANNING OF CLALLAM COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES SPERR
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:360-452-2954
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-0160
Mailing Address - Country:US
Mailing Address - Phone:360-452-2954
Mailing Address - Fax:360-457-7683
Practice Address - Street 1:1106 E 1ST ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-4317
Practice Address - Country:US
Practice Address - Phone:360-452-2954
Practice Address - Fax:360-457-7683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600258997000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7921109Medicaid
WAAB39834OtherMEDICARE ID#
WAAB39835OtherMEDICARE ID#
WAX98069Medicare UPIN
WA7921109Medicaid
WAAB39834Medicare PIN