1720024227 NPI number — FAMILY CARE NETWORK PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720024227 NPI number — FAMILY CARE NETWORK PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY CARE NETWORK PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTH SOUND FAMILY MEDICINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720024227
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
709 W ORCHARD DRIVE
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-0066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-318-9705
Provider Business Mailing Address Fax Number:
360-318-1085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2075 BARKLEY BLVD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-6614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-671-3345
Provider Business Practice Location Address Fax Number:
360-650-1354
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HIPSKIND
Authorized Official First Name:
MARCY
Authorized Official Middle Name:
G
Authorized Official Title or Position:
FAMILY CARE NETWORK PRESIDENT
Authorized Official Telephone Number:
360-318-9705

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 192942512 . This is a "US DEPT OF LABOR CLINIC NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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