| Im Professional Services Pllc | |
|
1040 Ne Hostmark St Ste 100a Poulsbo WA 98370-7337 | |
| (360) 779-4556 | |
| Not Available |
| Full Name | Im Professional Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1040 Ne Hostmark St Ste 100a, Poulsbo, Washington |
| Authorized Official Name and Position | Patrick Im (OWNER) |
| Authorized Official Contact | 3607794556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Im Professional Services Pllc 1040 Ne Hostmark St Poulsbo WA 98370-7337 Ph: (360) 779-4556 | Im Professional Services Pllc 1040 Ne Hostmark St Ste 100a Poulsbo WA 98370-7337 Ph: (360) 779-4556 |
| NPI Number | 1528757432 |
|---|---|
| Provider Enumeration Date | 05/05/2023 |
| Last Update Date | 05/10/2023 |
| Medicare PECOS PAC ID | 3274907787 |
|---|---|
| Medicare Enrollment ID | O20230324000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528757432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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