Provider Demographics
NPI:1598341786
Name:FAMILY CARE NETWORK, PLLC
Entity Type:Organization
Organization Name:FAMILY CARE NETWORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BANNERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
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
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:800 E. SUNSET DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-318-8800
Practice Address - Fax:360-318-1085
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE NETWORK, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty