# HIGHLINE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roxbury Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568713949
- **Authorized official:** VICKIE D JIMENEZ (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (206) 439-4887

## Contact information

- **Practice address:** 9635 17TH AVE SW, SEATTLE, WA 98106-2712
- **Practice address phone:** (206) 763-5057
- **Practice address fax:** (206) 763-5241
- **Mailing address:** 9635 17TH AVE SW, SEATTLE, WA 98106-2712
- **Mailing address phone:** (206) 763-5057
- **Mailing address fax:** (206) 763-5241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2012
- **Last updated:** 09/26/2012