Provider Demographics
NPI:1992997654
Name:PALUCH, NATALIE ROSE (MD)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ROSE
Last Name:PALUCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:ROSE
Other - Last Name:MASOG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:840 E HILL AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-2238
Practice Address - Country:US
Practice Address - Phone:509-765-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1992997654Medicaid
WA314846OtherLNI
WAG8919889, G8919888Medicare PIN
WA1992997654Medicaid