| |
7424 Bridgeport Way W Lakewood WA 98499-8120 | |
(253) 581-2111 | |
(253) 581-2712 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 7424 Bridgeport Way W, Lakewood, Washington |
Authorized Official Name and Position | Mary Bartolo (EXECUTIVE VICE PRESIDENT) |
Authorized Official Contact | 2067635277 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34703 Seattle WA 98124-1703 Ph: () - | 7424 Bridgeport Way W Lakewood WA 98499-8120 Ph: (253) 581-2111 |
NPI Number | 1346809308 |
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Provider Enumeration Date | 06/12/2019 |
Last Update Date | 06/15/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346809308 | NPI | - | NPPES |
2136153 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Aileen Leslie Wedvik Arnp Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4909 108th St Sw, Lakewood, WA 98499 Phone: 253-581-3075 Fax: 253-581-3178 | |
Washington Practice Management, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4901 108th St Sw, Lakewood, WA 98499 Phone: 253-984-7247 | |
Avalon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9315 Gravelly Lake Dr Sw, Suite 103, Lakewood, WA 98499 Phone: 253-582-8486 Fax: 253-582-2644 | |