Healthcare Provider Details

I. General information

NPI: 1831123769
Provider Name (Legal Business Name): THREE TREE WOMEN'S CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW SUITE 301
BURIEN WA
98166-3049
US

IV. Provider business mailing address

P.O. BOX 84526
SEATTLE WA
98124-5862
US

V. Phone/Fax

Practice location:
  • Phone: 206-246-0790
  • Fax: 206-246-1246
Mailing address:
  • Phone: 206-439-4898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00019798
License Number StateWA

VIII. Authorized Official

Name: CHRISTIE A. RECINTO
Title or Position: PARTNER
Credential: MD
Phone: 206-242-9000