Provider Demographics
NPI:1639788979
Name:HOUSE CALL DOCTORS OF PACIFIC NORTHWEST
Entity Type:Organization
Organization Name:HOUSE CALL DOCTORS OF PACIFIC NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMEMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-452-7166
Mailing Address - Street 1:10224 AIRPORT WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8203
Mailing Address - Country:US
Mailing Address - Phone:360-863-6696
Mailing Address - Fax:360-243-3185
Practice Address - Street 1:303 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8751
Practice Address - Country:US
Practice Address - Phone:360-863-6696
Practice Address - Fax:360-243-3185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty