Provider Demographics
NPI:1619038957
Name:MADIGAN ARMY MEDICAL CENTER.
Entity type:Organization
Organization Name:MADIGAN ARMY MEDICAL CENTER.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIANS ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:REID
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:253-967-7594
Mailing Address - Street 1:7224 RIDGEMONT DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513
Mailing Address - Country:US
Mailing Address - Phone:360-459-7280
Mailing Address - Fax:
Practice Address - Street 1:BLDG 11582
Practice Address - Street 2:17TH & C STREET
Practice Address - City:FT. LEWIS
Practice Address - State:WA
Practice Address - Zip Code:98433-1100
Practice Address - Country:US
Practice Address - Phone:253-966-7594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1103XAmbulatory Health Care FacilitiesClinic/CenterMilitary Ambulatory Procedure Visits Operational (Transportable)