| Eastside Premier Medicine Pllc | |
|
2950 Northup Way Suite 210 Bellevue WA 98004-1406 | |
| (425) 284-3377 | |
| (425) 827-1040 |
| Full Name | Eastside Premier Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2950 Northup Way, Bellevue, Washington |
| Authorized Official Name and Position | Stacey S. Donlan (PHYSICIAN) |
| Authorized Official Contact | 4252843377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Premier Medicine Pllc 2950 Northup Way Suite 210 Bellevue WA 98004-1406 Ph: (425) 284-3377 | Eastside Premier Medicine Pllc 2950 Northup Way Suite 210 Bellevue WA 98004-1406 Ph: (425) 284-3377 |
| NPI Number | 1518025618 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 12/06/2007 |
| Medicare PECOS PAC ID | 2062427321 |
|---|---|
| Medicare Enrollment ID | O20060208000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518025618 | NPI | - | NPPES |
| 2950DO | Other | WA | REGENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD00032729 (Washington) | Primary |
| Provider Name | Stacy S Donlan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740358290 PECOS PAC ID: 0042111221 Enrollment ID: I20060208000536 |
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