Organization
EDMONDS FAMILY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SVETLANA A BUGAICHUK (OFFICE MANAGER)
(425) 775-2066
Entity
Organization
Contact information
Practice address
6101 200TH ST SW, STE#208, LYNNWOOD, WA 98036-6077
(425) 775-2066
(425) 775-5306
Mailing address
6101 200TH ST SW, STE#208, LYNNWOOD, WA 98036-6077
(425) 775-2066
(425) 775-5306
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
602496426
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199257
LABOR&INDUSTRIES
WA
05
—
7128606
—
WA
Enumeration date
02/28/2007
Last updated
11/08/2021
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