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General NPI Number Information
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NPI Number | 1013107630
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Entity Type | Organization
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Legal Business Name | PACMED CLINICS
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 31833 GATEWAY CENTER BLVD S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5616
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Country | US
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Telephone | 253-214-1920
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Fax |
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Provider Business Mailing Address
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Address Line | 31833 GATEWAY CENTER BLVD S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5616
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Country | US
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Telephone | 253-214-1920
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECREATRY FOR ENROLLMENT
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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