| Organization Name: | HOPE FAMILY MEDICAL CLINIC, PLLC |
| NPI Number: | 1033419221 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ELSBETH JOHANN (FAMILY NURSE PRACTITIONER, BC) |
| Mailing Address: | 7614 195th St Sw Ste 203 Edmonds |
| State: | WA US |
| Postal Code: | 980266260 |
| Phone Number: | 4257440709 |
| Fax Number: | 4257711470 |
| NPI Enumeration Date: | 10/22/2010 |
| NPI Last Update Date: | 10/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | UBI 603 043 924 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |