Healthcare Provider Details

I. General information

NPI: 1114124435
Provider Name (Legal Business Name): THE DOCTORS CLINIC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 HILDEBRAND LN NE
BAINBRIDGE ISLAND WA
98110-2877
US

IV. Provider business mailing address

9621 RIDGETOP BLVD NW
SILVERDALE WA
98383-8502
US

V. Phone/Fax

Practice location:
  • Phone: 206-855-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: LINDA A. BROWN
Title or Position: CEO
Credential:
Phone: 360-782-3600