Provider Demographics
NPI:1750008637
Name:MARY E BACHKO
Entity type:Organization
Organization Name:MARY E BACHKO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHKO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP/CNM
Authorized Official - Phone:509-684-3584
Mailing Address - Street 1:158 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2802
Mailing Address - Country:US
Mailing Address - Phone:509-684-3584
Mailing Address - Fax:509-684-3852
Practice Address - Street 1:158 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2802
Practice Address - Country:US
Practice Address - Phone:509-684-3584
Practice Address - Fax:509-684-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Single Specialty