Delta Medical Clinic Llc | |
4215 198th St Sw Ste 102 Lynnwood WA 98036-6738 | |
(425) 725-9659 | |
Not Available |
Full Name | Delta Medical Clinic Llc |
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Speciality | Clinic/Center |
Location | 4215 198th St Sw Ste 102, Lynnwood, Washington |
Authorized Official Name and Position | Uyen N Nguyen (PRACTITIONER) |
Authorized Official Contact | 2067942015 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Delta Medical Clinic Llc 17806 5th Ave Ne Shoreline WA 98155-3513 Ph: (206) 794-9948 | Delta Medical Clinic Llc 4215 198th St Sw Ste 102 Lynnwood WA 98036-6738 Ph: (425) 725-9659 |
NPI Number | 1992401897 |
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Provider Enumeration Date | 02/01/2023 |
Last Update Date | 06/04/2024 |
Medicare PECOS PAC ID | 4688049513 |
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Medicare Enrollment ID | O20230406002639 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992401897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Uyen N Nguyen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699432666 PECOS PAC ID: 8325431109 Enrollment ID: I20220201000396 |
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