MEDICARE: PATRICIA L MCQUINN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA00012594	WA

General Provider Information

NPI Number	:	1972621662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA L MCQUINN

Provider Business Mailing Address
First Line	:	7631 212TH ST SW STE 106B
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-7565
Country	:	US
Telephone Number	:	206-618-1279
Fax Number	:

Provider Business Practice Location Address
First Line	:	7631 212TH ST SW STE 106B
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-7565
Country	:	US
Telephone Number	:	206-546-6666
Fax Number	:	206-400-2702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	12/19/2019

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