SNAKE RIVER ADULT MEDICINE LLC – NPI #1548752918
Clinic/Center

SNAKE RIVER ADULT MEDICINE LLC is an AHC clinic located in CLARKSTON, WA. NPPES has assigned the NPI number 1548752918 to SNAKE RIVER ADULT MEDICINE LLC on June 01, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 4 years ago on Jan 19, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SNAKE RIVER ADULT MEDICINE LLC below.

NPI Profile for
SNAKE RIVER ADULT MEDICINE LLC

NPI Number
1548752918
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SNAKE RIVER ADULT MEDICINE LLC
Primary location
1625 5TH ST
CLARKSTON, WA 99403-3001
Phone: (509) 295-8398 Fax: (509) 295-8416
1 Other location(s):
725 Diagonal St
Clarkston, WA 99403-2043
Phone: (509) 295-8398
Mailing address
725 DIAGONAL ST
CLARKSTON, WA 99403-2043
Phone: (509) 295-8398 Fax: (509) 295-8416
Organization Subpart
No
Authorized Official
BRIAN CIEZKI
OWNER/OPERATOR
Phone: (509) 295-8398
Updated
Certification Date
Jan 19, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)
WA 604282863

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.