Organization
PRIMARY CARE CLINIC FOR ADULTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN R WILSON MA (MEDICAL ASSISTANT)
(425) 806-8360
Entity
Organization
Contact information
Practice address
20011 BALLINGER WAY NE STE 202, SHORELINE, WA 98155-1286
(425) 806-8360
(425) 250-8566
Mailing address
20011 BALLINGER WAY NE STE 202, SHORELINE, WA 98155-1286
(425) 806-8360
(425) 250-8566
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30005666
WA
Other
Enumeration date
12/19/2007
Last updated
04/11/2023
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