Provider Demographics
NPI:1427001015
Name:FAMILY CARE NETWORK, PLLC
Entity Type:Organization
Organization Name:FAMILY CARE NETWORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY CARE NETWORK PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-318-8800
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:709 W ORCHARD DR
Practice Address - Street 2:SUITE 4
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1766
Practice Address - Country:US
Practice Address - Phone:360-318-8800
Practice Address - Fax:360-318-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7096456Medicaid
WACG1680OtherRAILROAD MEDICARE
WA0128737OtherL & I (REGULAR) GRP #
WA5871FAOtherREGENCE BLUESHIELD
WA192942500OtherUS DEPT OF LABOR
WA8924274OtherL & I (CV) GRP #
WA423898-000OtherGROUP HLTH COOP GRP #
WA5871FAOtherREGENCE BLUESHIELD