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SOUTH SOUND MEDICAL GROUP PLLC NPI 1285018432


NPI Information

NPI: 1285018432
Provider Name: SOUTH SOUND MEDICAL GROUP, PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
10116 COACHMAN LN SE
OLYMPIA, WA
ZIP 98501
Phone: (360) 556-8465
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SOUTH SOUND MEDICAL GROUP, PLLC is a family medicine in Olympia, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTH SOUND MEDICAL GROUP, PLLC NPI is 1285018432. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10116 COACHMAN LN SE
OLYMPIA, WA
ZIP 98501-731
Phone: (360) 556-8465

The provider's authorized official is Jessica Van Fleet-green .
The authorized official title is Owner/md and has the following contact phone number (360) 556-8465.

The enumeration date for this NPI number is 7/17/2015 and was last updated on 9/23/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineMD60162757WASHINGTONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11679736318MEDICAIDWASHINGTON
2G8900734MEDICARE PINWASHINGTON
31679736318OTHERWASHINGTONNPI

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

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