| |
7715 24th Ave Nw Seattle WA 98117-4412 | |
(206) 782-1133 | |
Not Available |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 7715 24th Ave Nw, Seattle, Washington |
Authorized Official Name and Position | Diane Salvesen (CLINIC MANAGER) |
Authorized Official Contact | 2067821133 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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7715 24th Ave Nw Seattle WA 98117-4412 Ph: (206) 782-1133 | 7715 24th Ave Nw Seattle WA 98117-4412 Ph: (206) 782-1133 |
NPI Number | 1639359706 |
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Provider Enumeration Date | 11/06/2007 |
Last Update Date | 11/06/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639359706 | NPI | - | NPPES |
7084874 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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