Providence Physician Group | |
12800 Bothell Everett Hwy Suite 120 Everett WA 98208-6642 | |
(425) 316-5150 | |
(425) 316-5153 |
Full Name | Providence Physician Group |
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Speciality | Durable Medical Equipment & Medical Supplies |
Location | 12800 Bothell Everett Hwy, Everett, Washington |
Authorized Official Name and Position | Earl D. Beegle (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 4253165470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Providence Physician Group 909 N Broadway Everett WA 98201-1409 Ph: (425) 317-0257 | Providence Physician Group 12800 Bothell Everett Hwy Suite 120 Everett WA 98208-6642 Ph: (425) 316-5150 |
NPI Number | 1639258130 |
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Provider Enumeration Date | 11/03/2006 |
Last Update Date | 11/21/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639258130 | NPI | - | NPPES |
7095367 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Community Health Center Of Snohomish County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 E Casino Rd, Everett, WA 98203 Phone: 425-789-3700 | |
Kidney And Arthritis Clinic P S Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3218 Nassau St, Everett, WA 98201 Phone: 425-259-9225 Fax: 425-339-3381 |