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Organization
EMERGENCY ROOMS, PS
Active
Organization
EMERGENCY ROOMS, PS
Active
Other names
Family Care & Urgent Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEANN M BIGONI (OPERATIONS)
(360) 695-9922
Entity
Organization
Contact information
Practice address
4421 NE ST JOHNS RD, SUITE F, VANCOUVER, WA 98661-2573
(360) 695-9922
(360) 695-1310
Mailing address
4421 NE ST JOHNS RD, SUITE F, VANCOUVER, WA 98661-2573
(360) 695-9922
(360) 695-1310
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829670001
MEDICARE TYPE UNSPECIFIED
WA
Enumeration date
03/13/2007
Last updated
08/06/2009
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