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7424 Bridgeport Way W Ste 202 Lakewood WA 98499-8134 | |
| (253) 581-2112 | |
| (253) 240-2102 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 7424 Bridgeport Way W Ste 202, Lakewood, Washington |
| Authorized Official Name and Position | Stephanie Lyn Fox (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2536816603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 7424 Bridgeport Way W Ste 202 Lakewood WA 98499-8134 Ph: (253) 581-2112 |
| NPI Number | 1609586932 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609586932 | NPI | - | NPPES |
| 2296285 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Brian Kerr Dmd Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8520 Steilacoom Blvd Sw, Suite 202, Lakewood, WA 98498 Phone: 253-584-6200 Fax: 253-984-6424 | |
Oral Surgery Northwest Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7424 Bridgeport Way W, Suite 311, Lakewood, WA 98499 Phone: 253-588-1701 Fax: 253-588-8832 | |
Christopher J Bates, Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10828 Gravelly Lake Dr Sw, Suite 111, Lakewood, WA 98499 Phone: 253-584-3121 Fax: 253-582-2484 | |
Dr. Nancy K. Rothbauer Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12502 Vernon Ave Sw, Lakewood, WA 98498 Phone: 253-582-9010 Fax: 253-582-1233 |