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NPI 1053184861

NPI 1053184861 : PREMISE HEALTH OF WASHINGTON MEDICAL, PC : KIRKLAND, WA

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General NPI Number Information
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    NPI Number           |    1053184861
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    Entity Type          |    Organization 
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    Legal Business Name  |    PREMISE HEALTH OF WASHINGTON MEDICAL, PC 
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Dates
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    Enumeration Date     |    11/02/2023
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    Last Update Date     |    01/29/2026
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Provider Practice Location Address
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    Address Line         |    747 6TH ST S 
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    City                 |    KIRKLAND
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    State                |    WA
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    Zip                  |    98033-6715
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    Country              |    US
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    Telephone            |    425-400-3245
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    Fax                  |    425-952-1801
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Provider Business Mailing Address
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    Address Line         |    5500 MARYLAND WAY STE 120 
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    City                 |    BRENTWOOD
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    State                |    TN
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    Zip                  |    37027-4993
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    Country              |    US
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    Telephone            |    615-468-6242
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    Fax                  |    615-468-6242
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     EDWARD WILLIAM SCHWARTZ 
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    Credential           |    
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    Telephone            |    844-407-7557
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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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