Organization
FAIRHAVEN FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M ALDRICH MD (MD)
(360) 755-0311
Entity
Organization
Contact information
Practice address
1030 EAST FAIRHAVEN AVENUE, BURLINGTON, WA 98233
(360) 755-0311
(360) 755-1272
Mailing address
PO BOX 468, BURLINGTON, WA 98233
(360) 755-0311
(360) 755-1272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00013642
WA
207Q00000X
Family Medicine Physician
Primary
MD00023548
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7816200
—
WA
01
—
S57930
REGENCE BLUE SHIELD
WA
Enumeration date
08/19/2006
Last updated
01/07/2009
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