| Molina Medical Group - Washington | |
|
15 Sw Everett Mall Way Suite A Everett WA 98208-2777 | |
| (562) 499-6191 | |
| (562) 499-6171 |
| Full Name | Molina Medical Group - Washington |
|---|---|
| Speciality | Family Medicine |
| Location | 15 Sw Everett Mall Way, Everett, Washington |
| Authorized Official Name and Position | Gloria Calderon (VP, CLINIC OPERATIONS) |
| Authorized Official Contact | 5624996191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Molina Medical Group - Washington 200 Oceangate Suite 100 Long Beach CA 90802-4317 Ph: (562) 499-6191 | Molina Medical Group - Washington 15 Sw Everett Mall Way Suite A Everett WA 98208-2777 Ph: (562) 499-6191 |
| NPI Number | 1891000725 |
|---|---|
| Provider Enumeration Date | 08/16/2010 |
| Last Update Date | 09/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891000725 | NPI | - | NPPES |
| 2010594 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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