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Organization
EASTSIDE MEDICAL GROUP, LLC
Active
Organization
EASTSIDE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HOWIE (TREASURER)
(425) 837-9720
Entity
Organization
Contact information
Practice address
1301 4TH AVE NW, ISSAQUAH, WA 98027-9371
(425) 270-3713
(425) 295-7557
Mailing address
1301 4TH AVE NW, SUITE 201, ISSAQUAH, WA 98027-9371
(425) 270-3713
(425) 295-7557
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
04/01/2014
Last updated
01/18/2017
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