Organization Name: | DEER PARK URGENT CARE PLLC |
NPI Number: | 1093741076 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIE A MORAN (OWNER/PRACTICIONER) |
Mailing Address: | 702 South Park Deer Park |
State: | WA US |
Postal Code: | 99006 |
Phone Number: | 5092629000 |
Fax Number: | 5092763034 |
NPI Enumeration Date: | 06/23/2006 |
NPI Last Update Date: | 08/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |