MEDICARE: PACIFIC NORTHWEST MEDICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1902188196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC NORTHWEST MEDICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 6116
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98064-6116
Country	:	US
Telephone Number	:	425-291-3300
Fax Number	:	425-291-5300

Provider Business Practice Location Address
First Line	:	18021 68TH AVE S
Second Line	:	SUITE 101
City	:	KENT
State	:	WA
Zip	:	98032-1020
Country	:	US
Telephone Number	:	425-291-3300
Fax Number	:	425-291-5300

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ANDREW TOAN LE
Credential	:	MD603437379
Telephone Number	:	425-291-3300

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	01/27/2026

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