Provider Demographics
NPI:1104001338
Name:ASIO FAMILY CARE
Entity Type:Organization
Organization Name:ASIO FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-946-5900
Mailing Address - Street 1:720 S 320TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5254
Mailing Address - Country:US
Mailing Address - Phone:253-946-5900
Mailing Address - Fax:
Practice Address - Street 1:720 S 320TH ST STE E
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5254
Practice Address - Country:US
Practice Address - Phone:253-946-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7132178Medicaid
WAG70318Medicare UPIN