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General NPI Number Information
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NPI Number | 1801135884
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Entity Type | Organization
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Legal Business Name | FEMME CLINIQUE
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 02/11/2013
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Provider Practice Location Address
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Address Line | 1900 116TH AVE NE SUITE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-3052
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Country | US
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Telephone | 425-647-1869
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Fax | 425-590-9949
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Provider Business Mailing Address
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Address Line | 1900 116TH AVE NE SUITE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-3052
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Country | US
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Telephone | 425-647-1869
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Fax | 425-590-9949
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Authorized Official
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Title or Position | OWNER
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Name | BO LEBASTCHI
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Credential |
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Telephone | 425-647-1869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | NT60120417
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License Number State | WA
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