Provider Demographics
NPI:1497214399
Name:NW MEDICAL LLC
Entity Type:Organization
Organization Name:NW MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:425-954-6538
Mailing Address - Street 1:103 MAIN AVE S STE 205
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-8197
Mailing Address - Country:US
Mailing Address - Phone:425-954-6538
Mailing Address - Fax:425-880-3983
Practice Address - Street 1:103 MAIN AVE S STE 205
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8197
Practice Address - Country:US
Practice Address - Phone:425-954-6538
Practice Address - Fax:425-880-3983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty