=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548819956
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY CARE NETWORK PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2019
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1610 GROVER ST STE C5
-----------------------------------------------------
City | LYNDEN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98264-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-354-4567
-----------------------------------------------------
Fax | 360-671-0065
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 709 W. ORCHARD DR. STE. 4
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-318-8800
-----------------------------------------------------
Fax | 360-318-1085
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | RODNEY J ANDERSON
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 360-318-8800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------