# PRIMARY CARE CLINIC FOR ADULTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386828846
- **Authorized official:** JACLYN R WILSON MA (MEDICAL ASSISTANT)
- **Authorized official phone:** (425) 806-8360

## Contact information

- **Practice address:** 20011 BALLINGER WAY NE STE 202, SHORELINE, WA 98155-1286
- **Practice address phone:** (425) 806-8360
- **Practice address fax:** (425) 250-8566
- **Mailing address:** 20011 BALLINGER WAY NE STE 202, SHORELINE, WA 98155-1286
- **Mailing address phone:** (425) 806-8360
- **Mailing address fax:** (425) 250-8566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP30005666 | WA | Yes |

## Other

- **Enumeration date:** 12/19/2007
- **Last updated:** 04/11/2023