KEY BRIDGE MEDICAL CLINIC LLC NPI 1679178099

NPI Information

NPI: 1679178099
Provider Name: KEY BRIDGE MEDICAL CLINIC LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 50D2216426

Address:
11318 BRIDGEPORT WAY SW STE A
LAKEWOOD, WA
ZIP 98499
Phone: (253) 533-3838
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KEY BRIDGE MEDICAL CLINIC LLC is a primary care clinic center in Lakewood, WA. KEY BRIDGE MEDICAL CLINIC LLC NPI is 1679178099. The provider is registered as an organization entity type.

The provider's business location address is:

11318 BRIDGEPORT WAY SW STE A
LAKEWOOD, WA
ZIP 98499-054
Phone: (253) 533-3838

The provider's authorized official is Kerbie Salvador A Barrantes .
The authorized official title is Owner and has the following contact phone number (253) 533-3838.

The CLIA number assigned to this NPI record is 50D2216426 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2020 and was last updated on 1/28/2021.

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	251E00000X	Home Health				No
2	261QP2300X	Clinic/Center	Primary Care			Yes

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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