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Organization
MOLINA HEALTHCARE OF WASHINGTON, INC
Active
Organization
MOLINA HEALTHCARE OF WASHINGTON, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA CALDERON (VP CLINIC OPERATIONS)
(562) 499-6191
Entity
Organization
Contact information
Practice address
3322 BROADWAY,, SUITE 200, EVERETT, WA 98201-4425
(562) 499-6191
(562) 499-6171
Mailing address
200 OCEANGATE,, SUITE 100, LONG BEACH, CA 90802-4317
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
12/01/2009
Last updated
09/27/2011
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