Organization
NORTHWEST CRITICAL CARE PHYSICIANS, P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L CLARK MD (OWNER)
(206) 790-2397
Entity
Organization
Contact information
Practice address
12844 MILITARY RD S, SUITE 404, TUKWILA, WA 98168-3045
(206) 790-2397
(425) 641-4827
Mailing address
17058 SE 58TH ST, BELLEVUE, WA 98006-5595
(206) 790-2397
(425) 641-4827
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1086784
—
WA
01
—
810000222
RR MEDICARE
WA
Enumeration date
05/28/2006
Last updated
10/20/2010
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