Provider Demographics
NPI:1265477368
Name:FAMILY CARE NETWORK PLLC
Entity Type:Organization
Organization Name:FAMILY CARE NETWORK PLLC
Other - Org Name:SQUALICUM FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY CARE NETWORK PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIPSKIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-318-9705
Mailing Address - Street 1:709 W ORCHARD DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-0066
Mailing Address - Country:US
Mailing Address - Phone:360-318-9705
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-7974
Practice Address - Fax:360-676-2567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE NETWORK PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-20
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA192942510OtherUS DEPT OF LABOR CLINIC