Healthcare Provider Details

I. General information

NPI: 1568523959
Provider Name (Legal Business Name): MEDICAL CENTER OF ORTING INC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 WASHINGTON AVE S
ORTING WA
98360-9802
US

IV. Provider business mailing address

PO BOX 669
ORTING WA
98360-0669
US

V. Phone/Fax

Practice location:
  • Phone: 360-893-2266
  • Fax: 360-893-2821
Mailing address:
  • Phone: 360-893-2266
  • Fax: 360-893-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EMAD NABIL GIRGIS
Title or Position: OWNER
Credential: MD PCP
Phone: 360-893-2266