Organization
THE POLYCLINIC PLLC
Active
Parent organization
THE POLYCLINIC PLLC
Other names
Optum - Ballard
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE POLYCLINIC PLLC
Authorized official
CRAIG PEPIN (PHYSICIAN/OWNER)
(206) 860-5414
Entity
Organization
Contact information
Practice address
1448 NW MARKET ST STE 200, SEATTLE, WA 98107-3743
(206) 329-1760
Mailing address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 329-1760
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/05/2015
Last updated
05/24/2024
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