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5023 S Barton Place Seattle WA 98118 | |
(206) 725-8043 | |
(206) 760-1359 |
Full Name | |
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Speciality | Clinic/center |
Location | 5023 S Barton Place, Seattle, Washington |
Authorized Official Name and Position | Prudencio Galvez Tible (PRESIDENT) |
Authorized Official Contact | 2067258043 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 18936 Seattle WA 98118 Ph: (206) 725-8043 | 5023 S Barton Place Seattle WA 98118 Ph: (206) 725-8043 |
NPI Number | 1053417675 |
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Provider Enumeration Date | 09/15/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1053417675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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