Organization
EASTSIDE FAMILY MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA G HEBERT (OFFICE MANAGER)
(425) 453-1039
Entity
Organization
Contact information
Practice address
1200 112TH AVE NE, STE C160, BELLEVUE, WA 98004-3732
(425) 453-1039
(425) 453-8955
Mailing address
1200 112TH AVE NE, STE C160, BELLEVUE, WA 98004-3732
(425) 453-1039
(425) 453-8955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006240
—
WA
Enumeration date
08/16/2006
Last updated
03/12/2008
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