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31405 18th Ave S Federal Way WA 98003-5433 | |
| (253) 681-6600 | |
| (253) 681-6645 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 31405 18th Ave S, Federal Way, Washington |
| Authorized Official Name and Position | Mary Bartolo (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 2067635277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 31405 18th Ave S Federal Way WA 98003-5433 Ph: (253) 681-6600 |
| NPI Number | 1114475878 |
|---|---|
| Provider Enumeration Date | 09/12/2016 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 7315831161 |
|---|---|
| Medicare Enrollment ID | O20170421000974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114475878 | NPI | - | NPPES |
| 2074726 | Medicaid | WA |
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