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Organization

4TH STREET MEDICAL CARE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANTOSA HO M.D. (OWNER)
(360) 659-4141
Entity
Organization

Contact information

Practice address
1602 4TH ST, MARYSVILLE, WA 98270-5014
(360) 659-4141
(360) 659-1712
Mailing address
1602 4TH ST, MARYSVILLE, WA 98270-5014
(360) 659-4141
(360) 659-1712

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
602329907
WA

Other

Enumeration date
02/04/2008
Last updated
12/08/2014
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