Provider Demographics
NPI:1467631424
Name:ADULT & CHILD MEDICINE LLC
Entity Type:Organization
Organization Name:ADULT & CHILD MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-533-1570
Mailing Address - Street 1:1207 N 200TH ST
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3213
Mailing Address - Country:US
Mailing Address - Phone:206-533-1570
Mailing Address - Fax:206-533-1668
Practice Address - Street 1:1207 N 200TH ST
Practice Address - Street 2:SUITE # 102
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3213
Practice Address - Country:US
Practice Address - Phone:206-533-1570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042748261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2227182OtherFIRST HEALTH
WA6175MIOtherREGENCE
WA1120534Medicaid
WA6175MIOtherREGENCE
WA2227182OtherFIRST HEALTH