Healthcare Provider Details

I. General information

NPI: 1720463995
Provider Name (Legal Business Name): SUMMIT URGENT CARE, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 FACTORIA BLVD SE SUITE A
BELLEVUE WA
98006
US

IV. Provider business mailing address

PO BOX 24105
SEATTLE WA
98124-0105
US

V. Phone/Fax

Practice location:
  • Phone: 425-903-3141
  • Fax: 425-903-3142
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANIRBAN DAS
Title or Position: MEDICAL DIRECTOR/PHYSICIAN
Credential: D.O.
Phone: 425-774-1538