Organization
NORTHWESTERN HEALTHCARE MANAGEMENT SERVICES LLC
Active
Other names
University Place Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MITRA HANJANI MD (OWNER)
(253) 564-4157
Entity
Organization
Contact information
Practice address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-4157
(253) 564-4813
Mailing address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-4157
(253) 220-2491
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2017
Last updated
07/28/2023
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