Fader Primary Care, Pllc | |
2513 152nd Ave Ne Redmond WA 98052-5574 | |
(425) 301-8190 | |
Not Available |
Full Name | Fader Primary Care, Pllc |
---|---|
Speciality | Family Medicine |
Location | 2513 152nd Ave Ne, Redmond, Washington |
Authorized Official Name and Position | Seth Fader (MEMBER/OWNER) |
Authorized Official Contact | 4253018190 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Fader Primary Care, Pllc Po Box 1281 Bellevue WA 98009-1281 Ph: (425) 301-8190 | Fader Primary Care, Pllc 2513 152nd Ave Ne Redmond WA 98052-5574 Ph: (425) 301-8190 |
NPI Number | 1700474749 |
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Provider Enumeration Date | 01/05/2021 |
Last Update Date | 01/05/2021 |
Medicare PECOS PAC ID | 3274949961 |
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Medicare Enrollment ID | O20210303002667 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700474749 | NPI | - | NPPES |
604544384 | Other | WA | STATE UBI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Seth P Fader |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225190978 PECOS PAC ID: 4688621246 Enrollment ID: I20050727001187 |
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