| Orcas Island Family Medicine, Pc | |
|
33 Urner Street Suite 5 Eastsound WA 98245 | |
| (360) 376-4949 | |
| (360) 376-5093 |
| Full Name | Orcas Island Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 33 Urner Street, Eastsound, Washington |
| Authorized Official Name and Position | David Lee Russell (OWNER) |
| Authorized Official Contact | 3603764949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orcas Island Family Medicine, Pc Po Box 1989 Eastsound WA 98245-1989 Ph: () - | Orcas Island Family Medicine, Pc 33 Urner Street Suite 5 Eastsound WA 98245 Ph: (360) 376-4949 |
| NPI Number | 1194778498 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 05/28/2008 |
| Medicare PECOS PAC ID | 1951393503 |
|---|---|
| Medicare Enrollment ID | O20040401001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194778498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | David L Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740233162 PECOS PAC ID: 4880592906 Enrollment ID: I20040416000532 |
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