1083740823 NPI number — PRIMARY CARE ASSOCIATES PS

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 1083740823 NPI number — PRIMARY CARE ASSOCIATES PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRIMARY CARE ASSOCIATES PS
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:
Provider Other Organization Name Type Code:
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:
1083740823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4122 FACTORIA BLVD SE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98006-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-865-8080
Provider Business Mailing Address Fax Number:
425-865-0977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4122 FACTORIA BLVD SE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98006-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-865-8080
Provider Business Practice Location Address Fax Number:
425-865-0977
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GAMRATH
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
425-865-8080

Provider Taxonomy Codes

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

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





Copyright © 2007-2025 www.npivalidator.com