Provider Demographics
NPI:1326170093
Name:FAMILY CARE NETWORK, PLLC
Entity Type:Organization
Organization Name:FAMILY CARE NETWORK, PLLC
Other - Org Name:EVERSON FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIPKSIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-318-8800
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 1:407 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247
Practice Address - Country:US
Practice Address - Phone:360-966-3441
Practice Address - Fax:360-966-0969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE NETWORK, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-09
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA50-3904Medicare ID - Type UnspecifiedRURAL HEALTH