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Contact Information

COUNTRY DOCTOR COMMUNITY CLINIC
2101 E YESLER WAY
SUITE 150
SEATTLE, WA98122-5959
 Phone: 206-299-1900
 Fax: 206-299-1920
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for COUNTRY DOCTOR COMMUNITY CLINIC

NPI # 1902027253
LBN Legal business name COUNTRY DOCTOR COMMUNITY CLINIC
Authorized official MARIA SAUCEDO - (CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 05/02/2007
Last updated 01/26/2024 - About 2 years ago
Identifiers
WA Other PHAR.CF.00004988 LICENSE NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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