Adult & Child Medicine Llc | |
1207 N 200th St Suite # 102 Shoreline WA 98133-3213 | |
(206) 533-1570 | |
Not Available |
Full Name | Adult & Child Medicine Llc |
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Speciality | Clinic/Center |
Location | 1207 N 200th St, Shoreline, Washington |
Authorized Official Name and Position | Irina D Milman (OWNER) |
Authorized Official Contact | 2065331570 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Adult & Child Medicine Llc 1207 N 200th St Suite # 102 Shoreline WA 98133-3213 Ph: (206) 533-1570 | Adult & Child Medicine Llc 1207 N 200th St Suite # 102 Shoreline WA 98133-3213 Ph: (206) 533-1570 |
NPI Number | 1467631424 |
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Provider Enumeration Date | 10/26/2007 |
Last Update Date | 10/18/2012 |
Medicare PECOS PAC ID | 7911973839 |
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Medicare Enrollment ID | O20040902000523 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467631424 | NPI | - | NPPES |
2227182 | Other | WA | FIRST HEALTH |
6175MI | Other | WA | REGENCE |
1120534 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | MD00042748 (Washington) | Primary |
Provider Name | Irina D Milman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295736981 PECOS PAC ID: 7012992860 Enrollment ID: I20040624000093 |
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