Provider Demographics
NPI:1174275341
Name:LINK COMMUNITY CLINIC PLLC
Entity Type:Organization
Organization Name:LINK COMMUNITY CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GENA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:POLING
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:253-279-1227
Mailing Address - Street 1:107 N TACOMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 N TACOMA AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-2631
Practice Address - Country:US
Practice Address - Phone:555-555-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1275141731OtherNPPES
WA1760538086OtherNPPES
WA1154977262OtherNPPES
WA1730734047OtherNPPES