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NPI Code Detail

MEDICARE: HUDSON'S BAY MEDICAL GROUP, INC., P.S.

MEDICARE: HUDSON'S BAY MEDICAL GROUP, INC., P.S.
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
1207Q00000XFamily Medicine Physician
2213E00000XPodiatrist
3363A00000XPhysician Assistant
4363L00000XNurse Practitioner
5363LF0000XFamily Nurse Practitioner
6207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942204664
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUDSON'S BAY MEDICAL GROUP, INC., P.S.
Provider Business Mailing Address
First Line : 100 E 33RD ST
Second Line : STE 206
City : VANCOUVER
State : WA
Zip : 98663-2776
Country : US
Telephone Number : 360-695-1334
Fax Number : 360-992-1159
Provider Business Practice Location Address
First Line : 100 E 33RD ST
Second Line : STE 206
City : VANCOUVER
State : WA
Zip : 98663-2776
Country : US
Telephone Number : 360-695-1334
Fax Number : 360-992-1159
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. KATHY HINTZ
Credential :
Telephone Number : 360-992-1155
Provider Enumeration Date : 06/09/2005
Last Update Date : 09/28/2022

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Directions to “HUDSON'S BAY MEDICAL GROUP, INC., P.S. ” Practice Location

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