=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710190608
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIMARY HEALTH CARE ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2007
-----------------------------------------------------
Last Update Date | 04/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2111 N NORTHGATE WAY STE 217
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-9018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-363-2136
-----------------------------------------------------
Fax | 206-363-0523
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2111 N NORTHGATE WAY STE 217
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-9018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-363-2136
-----------------------------------------------------
Fax | 206-363-0523
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. FRANK K MITCHELL
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 206-363-2136
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------