| Organization Name: | WHITE SALMON FAMILY PRACTICE CLINIC |
| NPI Number: | 1871898700 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA ANN SHORT (NURSE PRACTITIONER, OWNER) |
| Mailing Address: | 181jewett Blvd White Salmon |
| State: | WA US |
| Postal Code: | 986720050 |
| Phone Number: | 8312060921 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2011 |
| NPI Last Update Date: | 01/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | AP60192028 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |