Provider Demographics
NPI:1518145028
Name:FREELAND FAMILY MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:FREELAND FAMILY MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:360-331-4424
Mailing Address - Street 1:22405 5TH PL. WEST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021
Mailing Address - Country:US
Mailing Address - Phone:360-331-4424
Mailing Address - Fax:360-331-1679
Practice Address - Street 1:1689 E. MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249
Practice Address - Country:US
Practice Address - Phone:360-331-4424
Practice Address - Fax:360-331-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty