# COUNTRY DOCTOR COMMUNITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carolyn Downs Family Medical Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902027253
- **Authorized official:** MARIA SAUCEDO (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (206) 709-7112

## Contact information

- **Practice address:** 2101 E YESLER WAY, SUITE 150, SEATTLE, WA 98122-5959
- **Practice address phone:** (206) 299-1900
- **Practice address fax:** (206) 299-1920
- **Mailing address:** 2101 E YESLER WAY, SUITE 210, SEATTLE, WA 98122-5959
- **Mailing address phone:** (206) 299-1970
- **Mailing address fax:** (206) 299-1920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 01/26/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHAR.CF.00004988 | LICENSE NUMBER | WA |