Full Name | |
---|---|
Speciality | Family Medicine |
Location | 222 State Ave N, Kent, Washington |
Authorized Official Name and Position | Vincent H Schmitz (CFO) |
Authorized Official Contact | 2534598000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
222 State Ave N Kent WA 98030-4544 Ph: (253) 372-7788 | 222 State Ave N Kent WA 98030-4544 Ph: (253) 372-7788 |
NPI Number | 1811949928 |
---|---|
Provider Enumeration Date | 05/17/2006 |
Last Update Date | 05/15/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811949928 | NPI | - | NPPES |
7088933 | Medicaid | WA | |
7062938 | Medicaid | WA | |
45941 | Other | WA | STATE L&I |
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