| 4th Street Medical Care Pllc | |
|
1602 4th St Marysville WA 98270-5014 | |
| (360) 659-4141 | |
| (360) 659-1712 |
| Full Name | 4th Street Medical Care Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1602 4th St, Marysville, Washington |
| Authorized Official Name and Position | Santosa Ho (OWNER) |
| Authorized Official Contact | 3606594141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4th Street Medical Care Pllc 1602 4th St Marysville WA 98270-5014 Ph: (360) 659-4141 | 4th Street Medical Care Pllc 1602 4th St Marysville WA 98270-5014 Ph: (360) 659-4141 |
| NPI Number | 1659559409 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659559409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 602329907 (Washington) | Primary |
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