Pine Family Practice LLC

NPI #1770063968 in Sunnyside, Washington

Provider Information

NPI Number: 1770063968
Entity Type: Organization
Organization Name: Pine Family Practice LLC
Primary Specialty: Physician Assistant
Enumeration Date: Aug 16, 2018
Last Updated: Nov 7, 2018

Practice Location

Address: 2240 E LINCOLN AVE
City: Sunnyside
State: Washington
ZIP Code: 98944-2487
Phone: (509) 836-2367

Authorized Official

Name: MS. MARY PINE, PA
Title: OWNER/PROVIDER
Phone: (509) 778-2703

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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