Organization
SEQUIM PHYSICIAN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN L BERRY M.D. (OWNER)
(360) 683-4181
Entity
Organization
Contact information
Practice address
411 W WASHINGTON ST, SEQUIM, WA 98382-3343
(360) 683-4181
(360) 681-3454
Mailing address
PO BOX 755, SEQUIM, WA 98382-0755
(360) 683-4181
(360) 681-3454
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD00018876
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7098833
—
WA
01
—
AP30003686
LICENSE DIANE ROOT-RACINE
WA
01
—
AP30005395
LICENSE GLORIA REDMOND
WA
01
—
MD00018876
LICENSE ALLEN BERRY
WA
Enumeration date
05/05/2006
Last updated
08/22/2020
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