Organization
ORCHARD MEDICAL CLINIC
Active
Parent organization
ORCHARD MEDICAL CLINIC
Other names
GLENN A. PACIO
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORCHARD MEDICAL CLINIC
Authorized official
DR. GLENN A PACIO M.D. (OWNER)
(253) 474-7100
Entity
Organization
Contact information
Practice address
5320 ORCHARD ST W, UNIVERSITY PLACE, WA 98467-3633
(253) 474-7100
(253) 474-2677
Mailing address
7501 92ND AVENUE CT SW, LAKEWOOD, WA 98498-3973
(253) 588-0058
(253) 589-4862
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD000380965
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11155922
—
WA
01
—
711938001
GROUP HEALTH
WA
01
—
P00850060
RAILROAD MEDICAARE
GA
Enumeration date
01/27/2012
Last updated
02/16/2012
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