Basic Information
| Provider Information | |||||||||
| NPI: | 1245656883 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHEBE MD PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2103 HARRISON AVE NW | ||||||||
| Address2: | #2616 | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985022636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3602399515 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1016 TACOMA AVE | ||||||||
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| City: | SUNNYSIDE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989442263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098371500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2014 | ||||||||
| LastUpdateDate: | 03/06/2014 | ||||||||
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| AuthorizedOfficialLastName: | ACHEBE | ||||||||
| AuthorizedOfficialFirstName: | NGOZI | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3602399515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD00042897 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.