| Tacoma South Medical Clinic | |
|
2111 S 90th St Tacoma WA 98444-1822 | |
| (253) 539-9700 | |
| Not Available |
| Full Name | Tacoma South Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 2111 S 90th St, Tacoma, Washington |
| Authorized Official Name and Position | Cliff A Robertson (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2537796101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tacoma South Medical Clinic 2111 S 90th St Tacoma WA 98444-1822 Ph: (253) 539-9700 | Tacoma South Medical Clinic 2111 S 90th St Tacoma WA 98444-1822 Ph: (253) 539-9700 |
| NPI Number | 1275562928 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275562928 | NPI | - | NPPES |
| 0126502 | Other | WA | STATE L&I |
| 8926851 | Other | WA | STATE CRIME VICTIMS |
| 7093792 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD00041631 (Washington) | Primary |
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