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General NPI Number Information
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NPI Number | 1205776853
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Entity Type | Organization
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Legal Business Name | ANYWHERE CLINIC WASHINGTON PLLC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 4029 DEAN MARTIN DR
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City | LAS VEGAS
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State | NV
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Zip | 89103-4138
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Country | US
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Telephone | 702-848-2256
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Fax | 702-817-9443
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Provider Business Mailing Address
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Address Line | 2800 E MADISON ST STE 201
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City | SEATTLE
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State | WA
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Zip | 98112-4865
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | GRANT BULLOCK
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Credential | DO
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Telephone | 702-848-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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