# NORTHWEST PHYSICIANS MEDICAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Physican Care NW
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043513435
- **Authorized official:** DR. THEODORE BRIDGE M.D. (PRESIDENT)
- **Authorized official phone:** (206) 715-4652

## Contact information

- **Practice address:** 5920 100TH ST SW STE 31, LAKEWOOD, WA 98499-2751
- **Practice address phone:** (253) 584-3023
- **Practice address fax:** (253) 582-1222
- **Mailing address:** 5920 100TH ST SW STE 30, LAKEWOOD, WA 98499-2751
- **Mailing address phone:** (253) 830-2030
- **Mailing address fax:** (253) 830-2055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |

## Other

- **Enumeration date:** 12/07/2010
- **Last updated:** 10/02/2024