Provider Demographics
NPI:1447578562
Name:BARIGENS CLINIC PLLC
Entity Type:Organization
Organization Name:BARIGENS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANAFY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANAFY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-353-8146
Mailing Address - Street 1:24604 104TH AVE SE
Mailing Address - Street 2:#201
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5385
Mailing Address - Country:US
Mailing Address - Phone:206-592-5000
Mailing Address - Fax:206-824-9510
Practice Address - Street 1:24604 104TH AVE SE
Practice Address - Street 2:SUITE 201
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-5385
Practice Address - Country:US
Practice Address - Phone:206-353-8146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047459208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty