| Southcenter Medical Clinic | |
|
15215 52nd Ave S Ste 204 Tukwila WA 98188-2354 | |
| (206) 414-9412 | |
| Not Available |
| Full Name | Southcenter Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 15215 52nd Ave S Ste 204, Tukwila, Washington |
| Authorized Official Name and Position | Hong Danh Ngo (OWNER) |
| Authorized Official Contact | 2064149412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcenter Medical Clinic 11808 Se 189th Pl Renton WA 98058-7103 Ph: (206) 414-9412 | Southcenter Medical Clinic 15215 52nd Ave S Ste 204 Tukwila WA 98188-2354 Ph: (206) 414-9412 |
| NPI Number | 1427741727 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 07/19/2023 |
| Medicare PECOS PAC ID | 7416315197 |
|---|---|
| Medicare Enrollment ID | O20230628001775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427741727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Hong Danh Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821491838 PECOS PAC ID: 2668789496 Enrollment ID: I20230808002457 |
| Provider Name | Hong-an Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508338799 PECOS PAC ID: 8426477985 Enrollment ID: I20230824002375 |
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