Healthcare Provider Details

I. General information

NPI: 1639685811
Provider Name (Legal Business Name): EXCELLENT CARING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2017
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10564 5TH AVE NE STE 103
SEATTLE WA
98125
US

IV. Provider business mailing address

PO BOX 415
EDMONDS WA
98020-0415
US

V. Phone/Fax

Practice location:
  • Phone: 206-399-1434
  • Fax: 855-750-7844
Mailing address:
  • Phone: 425-422-2813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number603451042
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberAP60268401
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROGER S NEUMAIER
Title or Position: OWNER
Credential: ARNP
Phone: 425-422-2813