| Fifth Avenue Internal Medicine, Inc | |
|
10564 5th Ave Ne Ste 201 Seattle WA 98125-7200 | |
| (206) 367-1222 | |
| (206) 364-2664 |
| Full Name | Fifth Avenue Internal Medicine, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10564 5th Ave Ne Ste 201, Seattle, Washington |
| Authorized Official Name and Position | Joseph Thomas Palermo (OWNER) |
| Authorized Official Contact | 2063671222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fifth Avenue Internal Medicine, Inc 10564 5th Ave Ne Ste 201 Seattle WA 98125-7200 Ph: (206) 367-1222 | Fifth Avenue Internal Medicine, Inc 10564 5th Ave Ne Ste 201 Seattle WA 98125-7200 Ph: (206) 367-1222 |
| NPI Number | 1740367929 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740367929 | NPI | - | NPPES |
| 7107840 | Medicaid | WA | |
| 151558 | Other | WA | L&I GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OP0000836 (Washington) | Primary |
| 363LF0000X | Nurse Practitioner - Family | AP30005722 (Washington) | Secondary |
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