Organization
FIRCREST FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELINDA E SHAWLES (OFFICE COORDINATOR)
(253) 564-7701
Entity
Organization
Contact information
Practice address
1339 ALAMEDA AVE, FIRCREST, WA 98466-6552
(253) 564-7701
(253) 565-4688
Mailing address
1339 ALAMEDA AVE, FIRCREST, WA 98466-6552
(253) 564-7701
(253) 565-4688
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
601996685
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518150119
NPI
WA
01
—
1649558479
NPI
WA
Enumeration date
05/15/2007
Last updated
04/05/2012
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