# QUEEN ANNE FAMILY MEDICINE INC PS

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

## Provider details

- **NPI number:** 1679663967
- **Authorized official:** DR. BRUCE GARDNER MD (OWNER)
- **Authorized official phone:** (206) 284-6132

## Contact information

- **Practice address:** 1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
- **Practice address phone:** (206) 284-6132
- **Practice address fax:** (206) 284-2566
- **Mailing address:** 1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
- **Mailing address phone:** (206) 284-6132
- **Mailing address fax:** (206) 284-2566

## Taxonomy

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

## Other

- **Enumeration date:** 10/15/2006
- **Last updated:** 06/21/2018