| Sitara Medical Inc Ps | |
|
14841 179th Ave Se Ste 210 Monroe WA 98272-1127 | |
| (425) 802-2861 | |
| Not Available |
| Full Name | Sitara Medical Inc Ps |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 14841 179th Ave Se Ste 210, Monroe, Washington |
| Authorized Official Name and Position | Syed Hadi Jafar (OWNER) |
| Authorized Official Contact | 4258022861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sitara Medical Inc Ps 14340 Se 87th Pl Newcastle WA 98059-3429 Ph: (425) 802-2861 | Sitara Medical Inc Ps 14841 179th Ave Se Ste 210 Monroe WA 98272-1127 Ph: (425) 802-2861 |
| NPI Number | 1689864209 |
|---|---|
| Provider Enumeration Date | 07/30/2007 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689864209 | NPI | - | NPPES |
| 1120922 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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