Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Marys Corner Medical Clinic Inc Ps

Organization Family Medicine Physician · NPI 1104016138

Marys Corner Medical Clinic Inc Ps provides Family Medicine Physician services in Chehalis, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4254 Jackson Hwy
Chehalis, WA 98532 Not confirmed with CMS for 14 years — call before visiting
Phone: (360) 262-3966
Fax: (360) 262-3967
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X (WA)
Family Medicine Physician Taxonomy 207Q00000X · Licence MD00039760 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10004588 (WA)

Record details

NPI number1104016138
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Inglis — Office Manager · (360) 262-3966
NPI enumeratedJuly 26, 2007
Last updated in NPPESApril 26, 2012
Mailing address4254 Jackson Highway, Chehalis, WA 98532

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