| Physican Care Nw | |
|
5920 100th St Sw Ste 31 Lakewood WA 98499-2751 | |
| (253) 584-3023 | |
| (253) 582-1222 |
| Full Name | Physican Care Nw |
|---|---|
| Speciality | Family Medicine |
| Location | 5920 100th St Sw Ste 31, Lakewood, Washington |
| Authorized Official Name and Position | Theodore Bridge (PRESIDENT) |
| Authorized Official Contact | 2067154652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physican Care Nw 5920 100th St Sw Ste 30 Lakewood WA 98499-2751 Ph: (253) 830-2030 | Physican Care Nw 5920 100th St Sw Ste 31 Lakewood WA 98499-2751 Ph: (253) 584-3023 |
| NPI Number | 1043513435 |
|---|---|
| Provider Enumeration Date | 12/07/2010 |
| Last Update Date | 10/02/2024 |
| Medicare PECOS PAC ID | 3173796703 |
|---|---|
| Medicare Enrollment ID | O20111027000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043513435 | NPI | - | NPPES |
| Provider Name | David R Kennel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952345563 PECOS PAC ID: 1254380777 Enrollment ID: I20050125000619 |
| Provider Name | Ulrich Birlenbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922031475 PECOS PAC ID: 1456488808 Enrollment ID: I20100416000457 |
| Provider Name | Courtney Kennel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912261447 PECOS PAC ID: 9739329483 Enrollment ID: I20150807014419 |
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