Provider Demographics
NPI:1609047398
Name:CAM MEDICAL
Entity Type:Organization
Organization Name:CAM MEDICAL
Other - Org Name:MACFARLAN FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MACFARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-737-8885
Mailing Address - Street 1:PO BOX 4135
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99302-4135
Mailing Address - Country:US
Mailing Address - Phone:509-737-8885
Mailing Address - Fax:509-737-8887
Practice Address - Street 1:7525 W DESCHUTES PL
Practice Address - Street 2:SUITE 1A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7747
Practice Address - Country:US
Practice Address - Phone:509-737-8885
Practice Address - Fax:509-737-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8805903Medicare PIN
WAG58739Medicare UPIN