At Family Practice Group Ps | |
24604 104th Ave Se Ste 201 Kent WA 98030-5385 | |
(253) 854-9799 | |
Not Available |
Full Name | At Family Practice Group Ps |
---|---|
Speciality | Family Medicine |
Location | 24604 104th Ave Se Ste 201, Kent, Washington |
Authorized Official Name and Position | Amandeep Mann (PROVIDER) |
Authorized Official Contact | 2533946574 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
At Family Practice Group Ps 24604 104th Ave Se Ste 201 Kent WA 98030-5385 Ph: () - | At Family Practice Group Ps 24604 104th Ave Se Ste 201 Kent WA 98030-5385 Ph: (253) 854-9799 |
NPI Number | 1346938685 |
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Provider Enumeration Date | 04/25/2023 |
Last Update Date | 05/16/2023 |
Medicare PECOS PAC ID | 2163889502 |
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Medicare Enrollment ID | O20230531000887 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346938685 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Amandeep K Mann |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669914354 PECOS PAC ID: 6103195789 Enrollment ID: I20170713001966 |
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