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10025 Ne 186th St Bothell WA 98011-3839 | |
(425) 486-9131 | |
(425) 486-9490 |
Full Name | |
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Speciality | Family Medicine |
Location | 10025 Ne 186th St, Bothell, Washington |
Authorized Official Name and Position | Linda R Jeppesen (CEO) |
Authorized Official Contact | 4254869131 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 646 Bothell WA 98041-0646 Ph: (425) 485-3955 | 10025 Ne 186th St Bothell WA 98011-3839 Ph: (425) 486-9131 |
NPI Number | 1841399870 |
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Provider Enumeration Date | 09/22/2006 |
Last Update Date | 10/11/2012 |
Identifier | Type | State | Issuer |
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1841399870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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