# FAMILY PHYSICIANS GENERAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Physicians GC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770791816
- **Authorized official:** NINA SPALEK MD (PHYSICIAN)
- **Authorized official phone:** (206) 444-6533

## Contact information

- **Practice address:** 12459 AMBAUM BLVD SW STE A, BURIEN, WA 98146-2660
- **Practice address phone:** (206) 444-6533
- **Practice address fax:** (206) 439-0421
- **Mailing address:** 12459 AMBAUM BLVD SW STE A, BURIEN, WA 98146-2660
- **Mailing address phone:** (206) 444-6533
- **Mailing address fax:** (206) 439-0421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | MD00021620 | WA | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 04/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 122873 | L AND I | WA |
| 01 | — | 50D0944376 | CLIA | WA |
| 05 | — | 7113020 | — | WA |
| 01 | — | SP8107 | REGENCE | WA |