Healthcare Provider Details

I. General information

NPI: 1326404468
Provider Name (Legal Business Name): MEDICAL CONSULTING ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9226 BAYSHORE DR NW SUITE 230
SILVERDALE WA
98383-9196
US

IV. Provider business mailing address

PO BOX 608
TRACYTON WA
98393-0608
US

V. Phone/Fax

Practice location:
  • Phone: 360-692-6202
  • Fax: 360-698-5508
Mailing address:
  • Phone: 360-692-6202
  • Fax: 360-698-5508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER PELTZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-692-6202