Healthcare Provider Details

I. General information

NPI: 1275603631
Provider Name (Legal Business Name): PACIFIC WALK-IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 PACIFIC AVE SE
LACEY WA
98503-1109
US

IV. Provider business mailing address

3928 PACIFIC AVE SE
LACEY WA
98503-1109
US

V. Phone/Fax

Practice location:
  • Phone: 360-455-1350
  • Fax: 360-455-5354
Mailing address:
  • Phone: 360-455-1350
  • Fax: 360-455-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA RUTH SYLWESTER
Title or Position: OWNER
Credential: MD
Phone: 360-455-1350