Organization
MAIN STREET FAMILY MEDICINE, PLLC
Active
Other names
Main Street Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
HALEIGH SCHWARTZ (OFFICE MANAGER)
(360) 474-5905
Entity
Organization
Contact information
Practice address
6000 NE 88TH ST STE D102, VANCOUVER, WA 98665-0982
(360) 474-5905
(360) 639-8017
Mailing address
6000 NE 88TH ST STE D102, VANCOUVER, WA 98665-0982
(360) 474-5905
(360) 639-8017
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265473292
NPI
—
01
—
1346742954
NPI
—
01
—
1821879024
NPI
—
01
—
1912432584
NPI
—
Enumeration date
12/02/2024
Last updated
12/02/2024
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