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PROVIDENCE HEALTH & SERVICES - WA NPI 1003050709


NPI Information

NPI: 1003050709
Provider Name: PROVIDENCE HEALTH & SERVICES - WA

Doing Business As: PMG NW WA H P URGENT CARE

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
4112 HARBOUR POINTE BLVD SW
SUITE100
MUKILTEO, WA
ZIP 98275
Phone: (425) 347-6350
Get Directions

PROVIDENCE HEALTH & SERVICES - WA is a general practice in Mukilteo, WA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PROVIDENCE HEALTH & SERVICES - WA NPI is 1003050709. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pmg Nw Wa H P Urgent Care.

The provider's business location address is:

4112 HARBOUR POINTE BLVD SW
SUITE100
MUKILTEO, WA
ZIP 98275-457
Phone: (425) 347-6350
Fax: (425) 347-6335

The provider's authorized official is Marcy Nicol .
The authorized official title is Director Rcm Nwr Physician Division and has the following contact phone number (425) 317-0284.

The enumeration date for this NPI number is 4/24/2009 and was last updated on 3/28/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3208000000XPediatricsNo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G8877705MEDICARE PINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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