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720 Main St Ste 224 Mount Vernon WA 98273-3830 | |
| (360) 929-0180 | |
| (360) 679-4788 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 Main St, Mount Vernon, Washington |
| Authorized Official Name and Position | H Roksan Biktimir (CEO) |
| Authorized Official Contact | 3609290180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 3645 Arlington WA 98223-3645 Ph: (360) 929-0180 | 720 Main St Ste 224 Mount Vernon WA 98273-3830 Ph: (360) 929-0180 |
| NPI Number | 1114337714 |
|---|---|
| Provider Enumeration Date | 05/05/2014 |
| Last Update Date | 02/24/2021 |
| Certification Date | 02/24/2021 |
| Medicare PECOS PAC ID | 0345781456 |
|---|---|
| Medicare Enrollment ID | O20240917001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114337714 | NPI | - | NPPES |
| Provider Name | H Roksan Biktimir |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629139241 PECOS PAC ID: 1254872369 Enrollment ID: I20240924001050 |
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