Provider Demographics
NPI:1194786103
Name:DONALD J. GREGGAIN, M.D. PS
Entity type:Organization
Organization Name:DONALD J. GREGGAIN, M.D. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-751-1500
Mailing Address - Street 1:1271 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2846
Mailing Address - Country:US
Mailing Address - Phone:509-751-1500
Mailing Address - Fax:509-751-1504
Practice Address - Street 1:1271 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2846
Practice Address - Country:US
Practice Address - Phone:509-751-1500
Practice Address - Fax:509-751-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0203406OtherDL&I GROUP NUMBER
ID000010017948OtherREGENCE GROUP #
WA7114630Medicaid
ID8J935OtherBX/GROUP NUMBER
G17748Medicare UPIN
GACI8336Medicare PIN
WA0203406OtherDL&I GROUP NUMBER
WA7114630Medicaid
G24649Medicare UPIN