Healthcare Provider Details

I. General information

NPI: 1740600246
Provider Name (Legal Business Name): DRX WA URGENT CARE PROVIDERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15500 1ST AVE S SUITE 106
BURIEN WA
98148-1052
US

IV. Provider business mailing address

9000 HOLMAN RD NW SUITE A1
SEATTLE WA
98117-3418
US

V. Phone/Fax

Practice location:
  • Phone: 206-706-9001
  • Fax:
Mailing address:
  • Phone: 206-706-9001
  • Fax: 206-706-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DHIRENDRA KUMAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 224-766-9400