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General NPI Number Information
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NPI Number | 1467631424
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Entity Type | Organization
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Legal Business Name | ADULT & CHILD MEDICINE LLC
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 1207 N 200TH ST SUITE # 102
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City | SHORELINE
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State | WA
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Zip | 98133-3213
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Country | US
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Telephone | 206-533-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 N 200TH ST SUITE # 102
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City | SHORELINE
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State | WA
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Zip | 98133-3213
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Country | US
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Telephone | 206-533-1570
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Fax | 206-533-1668
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Authorized Official
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Title or Position | OWNER
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Name | DR. IRINA D MILMAN
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Credential | MD
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Telephone | 206-533-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD00042748
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License Number State | WA
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