MOSCOW PULLMAN OBGYN
NPI 1386709624
Obstetrics & Gynecology - Critical Care Medicine in Pullman, WA

Active since December 27, 2006CLIA 13D0879418 · Microscopy
1205 SE PROFESSIONAL MALL BLVD STE 102, PULLMAN, WA 99163(509) 332-7511(509) 334-4712 Get Directions Write a Review

NPPES record last updated: January 4, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Moscow Pullman Obgyn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOSCOW PULLMAN OBGYN (NPI 1386709624) is a healthcare organization registered as a critical care medicine in Pullman, Washington and active in the NPI registry since December 2006. The organization holds a CLIA Microscopy certificate valid through March 28, 2028 and lists Ric Minudri, Partner, as its authorized official.

NPPES Registry Identity

NPI1386709624
Entity TypeOrganization
Primary Taxonomy207VC0200X
Legal Business NameDEVLIN & HUBERTY PS
Location Address1205 SE PROFESSIONAL MALL BLVD STE 102Pullman, WA 99163-5423
Mailing Address623 South Main St #5Moscow, ID 83843-2983 · (208) 883-0133 · Fax (208) 882-8319
Fax(509) 334-4712
Organization SubpartNo
Authorized OfficialRic MinudriPartner · (509) 332-7511
Enumeration DateDecember 27, 2006
Last NPPES UpdateJanuary 4, 2012
NPI 1386709624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & Gynecology · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207VC0200X
License Licensed in ID · D40218
Definition

An obstetrician/gynecologist, who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

1205 SE PROFESSIONAL MALL BLVD STE 102, Pullman, WA 99163

Other Names 1

Doing Business AsMoscow Pullman Obgyn

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D0879418

Moscow Pullman Ob/Gyn · Moscow, ID
Active · expires Mar 28, 2028
CLIA Number13D0879418
Laboratory TypePhysician Office
Certificate Effective DateMarch 29, 2026
Certificate Expiration DateMarch 28, 2028
Laboratory DirectorCharles Richards
Laboratory Phone(208) 883-0813
Laboratory LocationMoscow Pullman Ob/Gyn623 S Main St #5, Moscow, ID 83843
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
1205 SE PROFESSIONAL MALL BLVD STE 102
PULLMAN, WA 99163
Nurse Practitioner (Women's Health)
1205 SE PROFESSIONAL MALL BLVD STE 102
PULLMAN, WA 99163

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386709624, enumerated as an "organization" on December 27, 2006.

The provider is located at 1205 SE PROFESSIONAL MALL BLVD STE 102 PULLMAN, WA 99163 and the phone number is (509) 332-7511.

Obstetrics & Gynecology with taxonomy code 207VC0200X and a focus in Critical Care Medicine.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to verify.