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General NPI Number Information
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NPI Number | 1215734876
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Entity Type | Organization
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Legal Business Name | PHILLIPS FAMILY MEDICINE & WELLNESS
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1045 S 320TH ST
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5179
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Country | US
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Telephone | 206-651-7920
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Fax | 253-499-7988
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Provider Business Mailing Address
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Address Line | 1045 S 320TH ST
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5179
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Country | US
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Telephone | 206-651-7920
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Fax | 253-499-7988
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY PHILLIPS
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Credential | MBA, HMA
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Telephone | 206-651-7920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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