Provider Demographics
NPI:1871756593
Name:FREELAND MEDICAL CENTER INC
Entity type:Organization
Organization Name:FREELAND MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ARTERBURY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:360-331-4424
Mailing Address - Street 1:PO BOX 1086
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-1086
Mailing Address - Country:US
Mailing Address - Phone:360-331-4424
Mailing Address - Fax:360-331-1679
Practice Address - Street 1:1689 E MAIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-1689
Practice Address - Country:US
Practice Address - Phone:360-331-4424
Practice Address - Fax:360-331-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001110261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE08669Medicare UPIN
G00110432Medicare PIN