Organization
CHILDREN'S CLINIC OF SOUTH SNOHOMISH COUNTY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GOVAERT (OFFICE MANAGER)
(425) 775-7464
Entity
Organization
Contact information
Practice address
21600 HWY 99, SUITE 290, EDMONDS, WA 98026-8012
(425) 778-0191
(425) 672-2110
Mailing address
21600 HWY 99, SUITE 290, EDMONDS, WA 98026-8012
(425) 778-0191
(425) 672-2110
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7077027
—
WA
Enumeration date
04/04/2008
Last updated
04/04/2008
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