Providence Physician Group | |
4112 Harbour Pointe Blvd Sw Suite 100 Mukilteo WA 98275-5457 | |
(425) 347-6330 | |
(425) 347-6335 |
Full Name | Providence Physician Group |
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Speciality | Family Medicine |
Location | 4112 Harbour Pointe Blvd Sw, Mukilteo, Washington |
Authorized Official Name and Position | Barbara Schumacher (PRO FEE CREDENTIALING MANAGER) |
Authorized Official Contact | 4253476330 |
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 Pbo/credentialing Everett WA 98201-1409 Ph: (425) 317-0246 | Providence Physician Group 4112 Harbour Pointe Blvd Sw Suite 100 Mukilteo WA 98275-5457 Ph: (425) 347-6330 |
NPI Number | 1184654139 |
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Provider Enumeration Date | 07/04/2006 |
Last Update Date | 03/11/2010 |
Identifier | Type | State | Issuer |
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1184654139 | NPI | - | NPPES |
7126964 | Medicaid | WA |
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