COUNTRY DOCTOR COMMUNITY CLINIC NPI 1891343075

NPI Information

NPI: 1891343075
Provider Name: COUNTRY DOCTOR COMMUNITY CLINIC

Doing Business As: COUNTRY DOCTOR HEP C CLINIC

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
1621 S JACKSON ST STE 201
SEATTLE, WA
ZIP 98144
Phone: (206) 299-1900
Get Directions

COUNTRY DOCTOR COMMUNITY CLINIC is a community health clinic center in Seattle, WA. COUNTRY DOCTOR COMMUNITY CLINIC NPI is 1891343075. The provider is registered as an organization entity type.
The provider Is Doing Business As Country Doctor Hep C Clinic.

The provider's business location address is:

1621 S JACKSON ST STE 201
SEATTLE, WA
ZIP 98144-277
Phone: (206) 299-1900
Fax: (206) 299-1900

The provider's authorized official is Susana Tantico .
The authorized official title is Director Of Finance and has the following contact phone number (206) 299-1937.

The enumeration date for this NPI number is 8/30/2019 and was last updated on 2/11/2020.

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	261QC1500X	Clinic/Center	Community Health			Yes

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
1	UBI601583685	OTHER	WASHINGTON	DEPARTMENT OF REVENUE

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »