Healthcare Provider Details

I. General information

NPI: 1225529407
Provider Name (Legal Business Name): MITCHELL INTERNATIONAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 5TH AVE STE 2900
SEATTLE WA
98101-2644
US

IV. Provider business mailing address

6220 GREENWICH DR
SAN DIEGO CA
92122-5913
US

V. Phone/Fax

Practice location:
  • Phone: 206-343-6100
  • Fax: 206-812-6405
Mailing address:
  • Phone: 858-368-7000
  • Fax: 858-547-5470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: NINA SMITH
Title or Position: EVP, GENERAL MANAGER
Credential:
Phone: 949-335-1500