Healthcare Provider Details

I. General information

NPI: 1992759815
Provider Name (Legal Business Name): MEDCARE CLINICS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 NW GILMAN BLVD
ISSAQUAH WA
98027-5327
US

IV. Provider business mailing address

1490 NW GILMAN BLVD
ISSAQUAH WA
98027-5327
US

V. Phone/Fax

Practice location:
  • Phone: 425-557-4227
  • Fax: 425-557-2858
Mailing address:
  • Phone: 425-557-4227
  • Fax: 425-557-2858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberMD00031289
License Number StateWA

VIII. Authorized Official

Name: DR. REINIER VAN COEVORDEN
Title or Position: MD
Credential:
Phone: 425-557-4227