Provider Demographics
NPI:1083625271
Name:EASTSIDE FAMILY HEALTH CENTER, P.S.
Entity Type:Organization
Organization Name:EASTSIDE FAMILY HEALTH CENTER, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARINKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-899-2525
Mailing Address - Street 1:11821 NE 128TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7210
Mailing Address - Country:US
Mailing Address - Phone:425-899-2525
Mailing Address - Fax:425-899-2526
Practice Address - Street 1:11821 NE 128TH ST
Practice Address - Street 2:STE D
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7210
Practice Address - Country:US
Practice Address - Phone:425-899-2525
Practice Address - Fax:425-899-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty