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1450 Northwest Lane Se Lacey WA 98503-6908 | |
| (360) 491-4460 | |
| (360) 491-3090 |
| Full Name | |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 1450 Northwest Lane Se, Lacey, Washington |
| Authorized Official Name and Position | Nicole Quinn (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Contact | 4255256715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34439 Seattle WA 98124-1439 Ph: (425) 525-6778 | 1450 Northwest Lane Se Lacey WA 98503-6908 Ph: (360) 491-4460 |
| NPI Number | 1033309604 |
|---|---|
| Provider Enumeration Date | 07/30/2007 |
| Last Update Date | 12/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033309604 | NPI | - | NPPES |
| 8944993 | Other | WA | L&I CRIME VICTIMS |
| 342006812 | Other | WA | MASTER LICENSE WASHINGTON |
| 7138694 | Medicaid | WA | |
| 223577 | Other | WA | L&I |
Saint Martin's University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Abbey Way Se, Lacey, WA 98503 Phone: 972-367-4845 | |
Providence Health & Services Washington Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Golf Club Rd Se, Suite 203, Lacey, WA 98503 Phone: 360-493-7469 Fax: 360-459-2023 | |
Sweet Medical Group, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4524 Intelco Loop Se, Lacey, WA 98503 Phone: 360-491-9890 Fax: 360-667-5135 | |
Pioneer Family Practice, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5130 Corporate Center Ct Se, Lacey, WA 98503 Phone: 360-413-8600 Fax: 360-413-8822 |