St. Paul Medical Clinic, P.s. | |
510 6th Ave S 101 Seattle WA 98104-3877 | |
(206) 240-0422 | |
Not Available |
Full Name | St. Paul Medical Clinic, P.s. |
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Speciality | Clinic/Center |
Location | 510 6th Ave S, Seattle, Washington |
Authorized Official Name and Position | Tony Pham (PHYSICIAN/OWNER) |
Authorized Official Contact | 2062400422 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Paul Medical Clinic, P.s. 510 6th Ave S Suite 101 Seattle WA 98104-3877 Ph: (206) 240-0422 | St. Paul Medical Clinic, P.s. 510 6th Ave S 101 Seattle WA 98104-3877 Ph: (206) 240-0422 |
NPI Number | 1265750830 |
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Provider Enumeration Date | 05/06/2010 |
Last Update Date | 11/15/2012 |
Medicare PECOS PAC ID | 9830388206 |
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Medicare Enrollment ID | O20110117000111 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265750830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | OP60001377 (Washington) | Primary |
Provider Name | Tony Pham |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881661775 PECOS PAC ID: 8527022243 Enrollment ID: I20080826000761 |
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