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1909 214th St Se Suite 110 Bothell WA 98021-8486 | |
(425) 488-4988 | |
(425) 488-4993 |
Full Name | |
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Speciality | Family Medicine |
Location | 1909 214th St Se, Bothell, Washington |
Authorized Official Name and Position | William Howe (CFO) |
Authorized Official Contact | 4258992606 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 102928 Pasadena CA 91189-2928 Ph: (425) 899-3868 | 1909 214th St Se Suite 110 Bothell WA 98021-8486 Ph: (425) 488-4988 |
NPI Number | 1902907165 |
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Provider Enumeration Date | 09/26/2006 |
Last Update Date | 11/06/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902907165 | NPI | - | NPPES |
CG2833 | Other | WA | MEDICARE RAILROAD |
7072358 | Medicaid | WA | |
CJ9678 | Other | WA | MEDICARE RAILROAD |
CQ2437 | Other | WA | MEDICARE RAILROAD |
CG8137 | Other | WA | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
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