Healthcare Provider Details

I. General information

NPI: 1245825868
Provider Name (Legal Business Name): CONTINUUM PALLIATIVE OF WA A NONPROFIT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SE EVERETT MALL WAY STE C
EVERETT WA
98208-2814
US

IV. Provider business mailing address

1000 SE EVERETT MALL WAY STE C
EVERETT WA
98208-2814
US

V. Phone/Fax

Practice location:
  • Phone: 425-961-9500
  • Fax: 425-645-6033
Mailing address:
  • Phone: 425-961-9500
  • Fax: 425-645-6033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL STERN
Title or Position: DIRECTOR
Credential:
Phone: 510-499-9977