Lacey Family Clinic | |
7503 Pacific Ave Se Lacey WA 98503-1874 | |
(253) 332-0892 | |
Not Available |
Full Name | Lacey Family Clinic |
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Speciality | Clinic/Center |
Location | 7503 Pacific Ave Se, Lacey, Washington |
Authorized Official Name and Position | Nayeon Kim (OWNER/MANAGER) |
Authorized Official Contact | 2533320892 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lacey Family Clinic 1006 N 7th Ave Sw Tumwater WA 98512-6316 Ph: () - | Lacey Family Clinic 7503 Pacific Ave Se Lacey WA 98503-1874 Ph: (253) 332-0892 |
NPI Number | 1508431693 |
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Provider Enumeration Date | 05/21/2021 |
Last Update Date | 07/15/2021 |
Medicare PECOS PAC ID | 6800290131 |
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Medicare Enrollment ID | O20210810000643 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508431693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Nayeon Kim |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306452883 PECOS PAC ID: 2860812807 Enrollment ID: I20201013003169 |
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