Provider Demographics
NPI:1730292616
Name:VALLEY WOMEN'S CLINIC PLLC
Entity Type:Organization
Organization Name:VALLEY WOMEN'S CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLEETER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-228-0722
Mailing Address - Street 1:17722 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5744
Mailing Address - Country:US
Mailing Address - Phone:425-228-0722
Mailing Address - Fax:425-271-2566
Practice Address - Street 1:17722 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5744
Practice Address - Country:US
Practice Address - Phone:425-228-0722
Practice Address - Fax:425-271-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7066772Medicaid