FERN LANE COMPANY LLC NPI 1497255293

NPI Information

NPI: 1497255293
Provider Name: FERN LANE COMPANY, LLC

Doing Business As: THRIVE DIRECT HEALTH CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
708 E MORRIS ST
SUITE B
LA CONNER, WA
ZIP 98257
Phone: (360) 630-5141
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FERN LANE COMPANY, LLC is a primary care clinic center in La Conner, WA. FERN LANE COMPANY, LLC NPI is 1497255293. The provider is registered as an organization entity type.
The provider Is Doing Business As Thrive Direct Health Care.

The provider's business location address is:

708 E MORRIS ST
SUITE B
LA CONNER, WA
ZIP 98257
Phone: (360) 630-5141
Fax: (866) 302-7491

The provider's authorized official is Brianna Wilson .
The authorized official title is Owner and has the following contact phone number (360) 941-5519.

The CLIA number assigned to this NPI record is 50D2146797 - other - clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2018 and was last updated on 1/15/2020.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes
2	261QP3300X	Clinic/Center	Pain			No

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

NPI Synchronization or Removal

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