Organization
DRX WA URGENT CARE PROVIDERS, PLLC
Active
Other names
Immediate Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL MICKELSEN (CREDENTIALING SPECIALIST)
(208) 292-0990
Entity
Organization
Contact information
Practice address
15870 1ST AVE S, SUITE 101, BURIEN, WA 98148-1213
(206) 242-2501
Mailing address
9000 HOLMAN RD NW, SUITE A1, SEATTLE, WA 98117-3418
(206) 706-9001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/29/2012
Last updated
08/07/2014
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