PRUDENCIO G TIBLE MD PC NPI 1053417675

NPI Information

  • NPI: 1053417675
  • Provider Name: PRUDENCIO G TIBLE MD PC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: RANIER BEACH MEDICAL CLINIC
  • Address: 5023 S BARTON PLACE
    SEATTLE, WA
    ZIP 98118
  • Phone: (206) 725-8043

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NPI Details

PRUDENCIO G TIBLE MD PC is a clinic center in Seattle, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PRUDENCIO G TIBLE MD PC NPI is 1053417675. The provider is registered as an organization entity type.
The provider Is Doing Business As Ranier Beach Medical Clinic.

The provider's business location address is:

5023 S BARTON PLACE
SEATTLE, WA
ZIP 98118
Phone: (206) 725-8043
Fax: (206) 760-1359

The provider's authorized official is Prudencio Galvez Tible .
The authorized official title is President and has the following contact phone number (206) 725-8043.

The enumeration date for this NPI number is 9/15/2006 and was last updated on 8/22/2020.

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
1261Q00000XClinic/CenterYes

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: 3/30/2025

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