Family Medicine Liberty Lake

NPI 1790013175 - Family Medicine - 207Q00000X

NPI Details
NPI 1790013175
Enumeration Date 11/24/2009
Last Updated 04/30/2015
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name SUSAN LYNN SUSAN
Position OWNER
Phone (509) 928-6700
Fax
Practice Location
2207 N MOLTER RD
SUITE 203
LIBERTY LAKE WA, 99019-7570, US
Phone (509) 928-6700
Fax
Business Location
2207 N MOLTER RD
SUITE 203
LIBERTY LAKE WA, 99019-7570, US
Phone (509) 928-6700
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Washington
License Number MD00028821
Remove 1790013175 NPI Number
 

According to our database, Family Medicine Liberty Lake NPI is 1790013175, taxonomy code is 207Q00000X and license number is MD00028821, license state is located at Washington. Family Medicine Liberty Lake physically located at 2207 N Molter Rd, Liberty Lake WA, 99019-7570. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1790013175 NPI number is provided on an as is basis without warranty of any kind. 1790013175 is maintained by the National Plan & Provider Enumeration System. The contents of Family Medicine Liberty Lake are for informational purposes only.