| |
16410 Smokey Point Blvd Arlington WA 98223-8415 | |
(360) 653-4569 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 16410 Smokey Point Blvd, Arlington, Washington |
Authorized Official Name and Position | Willis Clark Jones (ADMINISTRATOR) |
Authorized Official Contact | 3604352133 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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330 S Stillaguamish Ave Arlington WA 98223-1642 Ph: (360) 435-2133 | 16410 Smokey Point Blvd Arlington WA 98223-8415 Ph: (360) 653-4569 |
NPI Number | 1598704769 |
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Provider Enumeration Date | 06/05/2006 |
Last Update Date | 10/24/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598704769 | NPI | - | NPPES |
7073794 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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