EASTSIDE INTERNAL MEDICINE PLLC NPI 1023165594

NPI Information

EASTSIDE INTERNAL MEDICINE PLLC is a medical specialty clinic center in Kirkland, WA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). EASTSIDE INTERNAL MEDICINE PLLC NPI is 1023165594. The provider is registered as an organization entity type.

The provider's business location address is:

12333 NE 120TH LN. STE 310
KIRKLAND, WA
ZIP 98034
Phone: (425) 899-6700
Fax: (425) 899-6701

The provider's authorized official is Douglas A Portelance .
The authorized official title is Md President and has the following contact phone number (425) 899-6700.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 12/18/2007.

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:

Other Identifiers

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

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